European Journal of Molecular & Clinical Medicine

Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. In patients with Type 2 diabetes, low grade inflammation is reflected by increased plasma levels of several biomarkers  such as C-reactive protein (CRP).Alkaline phosphatase (ALP) is a generally accepted clinical marker of hepatic or bone disease.It had been showed that elevated ALP acted as a prognostic indicator of decreased survival in diabetic patients with acute myocardial infarction (MI), possibly in association with decreased renal function in these patients

Type II DM is characterized by insulin resistance and hyperglycaemia, which increase the chances of dyslipidemia, obesity and hypertension, thereby increasing the risk of cardiovascular disease. Left ventricular diastolic dysfunction (LVDD) is the first stage of dilated cardiomyopathy and an important predictor of heart failure in patients with T2DM. Materials and Methods: Demographic details were taken from all cases and controls. Height and weight were taken and Body mass index was calculated. After overnight fasting, blood analysis for Blood glucose levels, both fasting and post parandial, lipid profile and renal profile. Velocities of Transmitral early diastolic filling (E-wave), atrial contraction late filling (A wave) were measured using 2D doppler, isovolumteric relaxation time and deceleration time were also measured for all the case and control subjects.
Results: The fasting blood sugar among the male was 147.2 ± 22.1mg/dL and post parandial it was 269.8 ± 15.2mg/dL, while among the females it was 142.9 ± 18.5mg/dL and 273.1 ± 13.9dL respectively in the cases, while the same was in the normal range in the controls. The lipid profile was also significantly higher in the cases and normal in the controls. The E/A ratio among the patients was 0.72 ± 0.2 in males and 0.77 ± 0.1 in females and in controls the same was 1.23 ± 0.4 and 1.11 ± 0.2 respectively, showing a significance difference. The E/e ratio was 19.1 ± 4.6 and 19.2 ± 5.1 in males and females respectively in patients and 8.4 ± 1.3 and 8.9 ± 2.1 in males and females of the controls respectively. The IVRT also was significantly different with 78 ± 3.1 in males and 79.2 ± 4.4 of the females and 96.4 ± 3.7 in males and 97.2 ± 2.9 in females of the controls. Diastolic dysfunction was present in 38 (60%) of the males and 23 (62.2%) of the females among the patients and in 4 (6.3%) of the males and 3(8.1%) of the females among the controls.
Conclusion: Early detection of Diastolic dysfunction in patients with Type II diabetes mellitus will help in taking corrective on time and prevent mortality at a later stage

To quantify the anthropometry, morbidity pattern, and mortality among infants of diabetic mothers.
Method: A cross-sectional observational study was conducted at the Department of Pediatrics at Siddhartha Medical College in Vijayawada. The study includes  total 260 neonates among 60 neonates born to mothers with gestational diabetes mellitus or overt diabetes mellitus. Data related to the mode of delivery, gestational age, birth weight, associated morbidities, investigations, and outcomes were collected.
Results: Of the 60 neonates studied, 48 (80%) were born to mothers with Gestational Diabetes Mellitus, and 12 (20%) were born to mothers with Overt Diabetes Mellitus. Babies born to diabetic mothers have a significantly higher mean birth weight (3.05kg) than babies born to non-diabetic mothers (2.767kg) [p=0.001]. 81.6% of diabetic mothers are born with normal birth weight. The most common morbidity in neonates born to gestational diabetes mellitus (GDM) mothers compared to overt diabetes mellitus (DM) mothers was hypoglycemia in 20 cases (33.33%), hypocalcemia in 6 cases (10%), hyperbilirubinemia in 17 cases (28.33%), polycythemia in 3 cases (5%), birth asphyxia in 3 cases (5%), respiratory distress in 16 cases (26.6%), and congenital heart diseases in 15 babies (25%). In total, 5.67 percent of the 260 population had congenital anomalies. Three babies died out of a total of 60, with two born to gestational diabetes mothers and one born to a pre-gestational diabetes mother.
Conclusion: The study shows disproportionate growth in the Infants of diabetic Mothers as evidenced by higher mean birth weight and mean ponderal index, morbidity and mortality were more common in the infants of GDM mothers when compared to overt DM mothers with good glycemic control. Metabolic problems and respiratory complications were common in the LGA of IDMs, and they need close monitoring.

This article is based on the prevalence of diabetes mellitus in Indian young people. This study focuses on the reason for increasing diabetes and it has been seen that employment and education is the major issues that make an impact on society. On the other hand, people are to much addicted to junk food, processed and ready-to-eat food that use harmful chemicals and artificial food substances. It may be responsible for hormonal imbalance and major health issues. Accordingly, this paper also discussed the psychological impact of diabetes Mellitus in the Indian young generation. There are two kinds of diabetes and both effects the other organs such as the kidney, liver, cornea, foot, skin, and many more

Diabetes mellitus is a disease that occurs due to the partial or complete dysfunctioning of the pancreas, thereby reducing the amount of insulin secretion in the body. Type II diabetes mellitus is commonly seen in the middle age group individuals, and can lead to a variety of systemic consequences involving multiple systems. One of the known complications of diabetes mellitus is hearing loss and tinnitus. The degenerative process, owing to type II diabetes mellitus affects the microvasculature of the hearing apparatus, the cochlea and the cochlear nerve

Cardiovascular problems brought on by ageing and the premature atherosclerosis unique to DM are the most common consequences.Thus Geriatric Diabetic patients have a high prevalence of cardiovascular disease (CVD). Coronary Artery diseases,Heart failure,Diabetic Autonomic cardiomyopathy causing arrhythmias are more common type of cardiovascular diseases in these group of patients.
Materials and Methods: The present prospective cross sectional hospital based observational study was conducted among 150 Geriatric patients with Type 2 diabetes Mellitus. A detailed clinical history was taken from all the patients regarding symptoms of Diabetes Mellitus Type 2.  The data was collected and entered into a spread sheet application (Microsoft9 Excel ).
Results: Majority of the study participants were among 60-70 years (89.33%) and least being >80 years(0.67%) .Majority of the study participants were females with 50.67% and 49.33% were males.
considering BMI,47.61% cases were Overweight (25-30) and 15.65% cases were Obese (>30).Major duration of DM among study population was 10-20 years(50.67%) followed by <10 years (27.33%).Major symptoms suggestive of cardiovascular involvement was palpitation 44% followed by 37.33% fatigue.Major signs suggestive of cardiovascular involvement was crepitations 13.33%, followed by 10% pedal edema. Major chest x-ray finding was cardiomegaly 12%, followed by 6.67% Pleural effusion.Major ECG changes considering infarction was NSTEMI 15.33% followed by 12% STEMI.Major ECG changes considering arrhythmias was sinus tachycardia 18% followed by 6.67% sinus bradycardia, 0.67% atrial fibrillation, 1.33% VPC, 19.33% LVH and 0.67% BBB.Major 2D Echo findings was 36.67% LVDD followed by 32.67% had Hypokinesia, 31% akinesia, 27.33% LVSD.It was observed that Around 62% had no cardiovascular involvement, 31.33% had Myocardial infarction, 20.67% arrythmia, 12.67% heart failure and 12% Diabetic cardiomyopathy (HCM+DCM).
Conclusion: Geriatric Diabetics are at significantly increased risk for cardiovascular disease. Myocardial Infarction is commonest cardiovascular abnormality detected.ECG and Echocardiography are basic yet most sensitive diagnostic procedure to detect CVD at an early stage .

A reliable predictive indicator for the course of critically ill patients' conditions is lactate. Metformin users have increased lactate levels at ICU admission without a concurrent rise in mortality, according to a number of small studies. In a wide range of patient populations, elevated lactate has been linked to greater mortality. The purpose of this study was to evaluate lactate levels and compare 30 days mortality in intensive caredunit patients who had and had not previously received metformin medication. Material and Method: This study included patients admitted in intensive care units of Assam medical college between June 2021 to May 2022 with at least one blood lactate level between 12 hr. before until 6 hr after ICU admission. The statistical analysis of the data was done with Microsoft Excel 2010 and the statistical package for social sciences, SPSS for Windows, version 20.0. Chicago: SPSS Inc. Results: The mean lactate in survivors was 3.05 mmol/L with a standard deviation of 2.41 and was lower than that in non-survivors, where it was 4.01 mmol/L with a standard deviation of 2.39.  Non-survivors had a higher distribution of lactate levels than do survivors. Since the p-value was 0.001, which was highly significant, it may be concluded that lactate levels and survival were related. Metformin was used by both 64% of survivors and 30% of non-survivors. 36% of those who did not take metformin lived, compared to 70% of users. The use of metformin and survival were significantly correlated, as shown by the p-value of 0.001, which was highly significant. Conclusion: Lactate concentrations were significantly correlated with mortality in this observational study. Early lactate levels were an important predictor of mortality in critically ill patients admitted to the intensive care unit, and higher preadmission metformin use in survivors demonstrated metformin's important contribution to higher survival rates.

Background: Stroke or cerebrovascular accident is a leading cause of mortality and morbidity throughout the world including both developed and developing countries. Identification of potential prognostic factors for ischaemic stroke may enable better prediction for outcome and conducting early interventions may improve the prognosis. Present study was aimed to study outcome of patients of acute ischemic stroke at tertiary care hospital. Material and Methods: Present study was prospective, observational study, conducted in patients with ischemic stroke, confirmed by CT scan of brain, presenting within 72 hours of onset of symptom, willing to participate in study. Results: In present study 126 patients with acute ischemic stroke were included.  Most common age group was 61-70 years (34.13 %) followed by 51-60 years (24.6 %) age group. Male patients (65.38 %) were more than female patients (34.13%). Male to female ratio was 1.9:1. Common risk factors observed were stage 1 hypertension (19.84 %), stage 2 hypertension (SBP>160, DBP>100) (25.4 %), diabetic (36.51 %), smoker (29.37 %), alcoholic (22.22 %), dyslipidemia (20.63 %), history of cardiovascular disease (18.25 %), obesity (15.87 %), family history of stroke (14.29 %) & tobacco chewing (10.32 %). On admission, according to NIHSS scale severity majority had minor stroke (37.3 %) followed by moderate stroke (35.71 %), moderate to severe stroke (18.25 %) & severe stroke (8.73 %). Functional outcome was assessed using the modified ranking score (MRS) at 6 months. Majority had MRS score 3 (44.29 %) followed by MRS score 2 (38.06 %), MRS score 1 (7.96 %). Conclusion: Areas for improvement in management of stroke are  public awareness, lifestyle modification (modifiable risk factors are hypertension, smoking, dyslipidemia, alcohol consumption, and diabetes mellitus), early diagnosis, treatment &  availability of facilities and expertise.

The term "diabetic nephropathy" refers to a clinical syndrome that includes persistent albuminuria, a consistent decrease in glomerular filtration rate (GFR) that eventually leads to end-stage renal disease, elevated arterial blood pressure, and increased cardiovascular morbidity and mortality. The apparent diffusion coefficient (ADC) has shown potential as a marker of renal function in several investigations, with decreased renal ADC in kidney disease. The aim of this study was to assess the difference in apparent diffusion coefficient (ADC) value in normal and diabetic kidney.
Methods: This was a cross sectional analytical study conducted from January 2021 to October 2022 in in Department of Radio diagnosis with the help of Department of Medicine. The cases coming to the Department of Medicine for routine follow up fulfilling the inclusion (age >18 years of diabetes mellitus with history of diabetic nephropathy). The MRI examination was performed using a 3 Tesla system.Binary logistic regression analysis was used for estimating the parameters of a logistic model (the coefficients in the linear combination). The p-value was taken significant when less than 0.05 and confidence interval of 95% was taken.
Results: In the study 26 (52%) cases were of diabetes mellitus while 24 (48%) cases were taken as control who were non diabetic. Out of 26 cases, majority belong to the stage 3 (46.2%) followed by the stage 4 and stage 5 with 6 (23.1%) cases each. The study included 1 case each of Stage 1 and stage 2. The ROC Analysis to find Accuracy of ADC Parameters for Detecting DM revealed that Lt, Rt and overall ADC values are highly accurate for detecting DM cases as their AUROC values comes out to be 0.999, 0.960 and 1.000 respectively, the very close/equal to perfect standard 1.000.
Conclusion: The magnetic resonance imaging- Apparent diffusion Coefficient (ADC) value is an appropriate method for assessment and evaluation of diabetic nephropathy. Renal ADC values show a significant correlation with clinical stages of diabetic nephropathy, it is a reliable diagnostic tool for differentiation between diabetic nephropathy patients from diabetic patients without nephropathy

Diabetes mellitus (DM) is one of the important health problems affecting the major populations worldwide. Diabetes mellitus, endocrine disorder which involves multiple organ systems and leads to significant morbidity and mortality due to accompanying complications. Thyroid diseases and diabetes mellitus are common endocrine disorders. The present study is carried out for the assessment of thyroid dysfunction in type 2 diabetic patients by measurement of serum T3, serum T4 and serum TSH levels.
Materials & method: This study was conducted in Department of Biochemistry in association with Department of Medicine, Index Institute for Medical Sciences & Research Center, Indore. A total of 300 subjected were enrolled into the study. They were divided into 2 groups, 150 age and sex matched healthy subjects were taken as group I (controls) (HbA1c: 5.5 to 6.5 %) and 150 type 2 diabetes mellitus subjects were taken as group II (HbA1c: >7.5 %). Age of the study subjects was 30 to 70 years. Under aseptic conditions, 5 mL Fasting venous blood sample is collected from all subjects in vacutainers, Serum sample was used for the estimation of Fasting sugar (GOD-POD method) by using ERBA EM360 fully analyzer, thyroid profile by ELISA method, and EDTA sample is used for estimation of HbA1c by using Resin Binding Method. Data were expressed as mean ±SD. P value
Results: fasting blood sugar and HbA1c levels were significantly increased in T2DM (group II) subjects compared with controls (group I). T3 levels were significantly decreased and TSH levels were significantly increased in T2DM subjects compared to controls. HbA1c is positively correlated with TSH.
Conclusion: In this present study, we have observed that the abnormal thyroid hormone levels among type 2 diabetics. Therefore, there is a need for the routine assay of thyroid hormones in type 2 diabetes mellitus in order to improve the quality of life and reduce the morbidity.

Diabetes mellitus is characterized by recurrent or persistent hyperglycemia, and is diagnosed by demonstrating any one of the following (WHO, 1999): Fasting plasma glucose level at or above 126 mg/dL (7.0mmol/l).  plasma glucose at or above 200 mg/dL or 11.1 mmol/l two hours after a 75 g oral glucose load as in a glucose tolerance test.
Objectives- To find the actual prevalence of diabetes mellitus in various professionals in Jhansi city. To study the various epidemiological factors associated with Diabetes mellitus.
 Methods- It is a cross sectional study (prevalence) which was conducted in urban area of Jhansi city. The study was conducted in University and Degree College (teachers), Banks (bank employee), Court (lawyers), and various other professional groups (businessmen). We took 100 members in each professional group. We took 100 bank workers in different banks, 100 teachers of Degree College or university, 100 lawyers and 100 different kinds of businessmen.

To determine the clinical and radiological features of pulmonary TB in diabetic mellitus patients.
Methods and materials: After receiving approval from the ethics council, the study was conducted on 100 individuals with DM and PT. A comprehensive history, clinical examination, sputum analysis for acid fast bacilli, and chest radiography were used to diagnosis PT. The clinical profile, pertinent tests, and radiological data were collated and analysed.
Results: Males made up 55 percent of the study sample, while females made up 45 percent. Cough (75%), fever (65%), and anorexia (77%) were the most common symptoms reported. Other symptoms included hemoptysis (13%), weight loss (51%), dyspnea (21%), chest discomfort (21%), and night sweats (41%). 24% of the patients had a history of tuberculosis, 13% had related hypertension, 9% had associated ischemic heart disease, 67% of male patients were smokers, and 9% had a family history of tuberculosis. Right sided lung lesions were found in 45% of patients over 45 years old and 31.67% of cases under 45 years old, whereas left sided lesions were found in 27.5% of cases under 45 years old and 28.33% of cases over 45 years old. Bilateral lesions were seen in 27.5% of individuals under the age of 45 and 40% of cases beyond the age of 45. Lesions in the lower lung field were seen in 43% of the patients. The chest x-ray revealed a cavity in 30% of the patients, a fibrous cavity in 11% of the patients, and an infiltrative lesion in 9% of the patients. Consolidation (7%), pleural effusion (7%), hydro pneumothorax (3%), parenchymal opacity (2%), and bronchiectasis (4%) were also seen.
Conclusion: Severe hyperglycemia seems to be a risk factor for diabetics developing pulmonary TB. Diabetes seems to have no influence on the presenting characteristics of pulmonary TB.

Yoga asanas and pranayama can control the blood sugar in a cost-effective manner, as there is no requirement of any sophisticated equipment with maximum space or fitness classes. The aim of this study to evaluate the effect of Yoga on blood sugar and body mass index (BMI) values for different time durations of Yoga training at tertiary care center.
Materials & Methods: A cross sectional observational study done on 200 subjects of both the genders in the age group 20-50 years were performed in the Department of physiology and Lala Lajpat Rai Memorial (LLRM) Medical College, Meerut, U.P., India during one year period. Subjects performed asanas supervised by primary investigator, in sitting, standing and lying position for 45 minutes daily, five days a week. Each asana was performed for 3 repetitions and the end position of each repetition was hold for 30 seconds. Purak and Rechak (deep breathing) was coordinated with the different posture of every asana. Thirty seconds rest period was given between each asana. Cool down was done with Shavasana for 5 minutes.Appropriate descriptive and implemented statistics were carried out using SPSS (Statistical Package for Social Sciences) version 22.0 software.
Results: Our study showed that 62% of participants were between 41-50 years among males and 92% of participants between 31-50 year’s  in females. Both male and female participants showed a negative correlation between the blood sugar level and yoga performance. Also, a negative correlation existed between the BMI and their yoga performance. Positive correlation is seen between the blood sugar levels and BMI values in both genders.
Conclusion: Yoga cannot cure diabetes but keeps a beneficial check on blood sugar values. Hence yoga is more of cost effective, does not need any equipment as in exercise, it can be done within four walls   with adequate ventilation and long term effect of this yoga can explore the beneficial effects on glucose and other hormonal homeostasis, insulin sensitivity, it can improve cognition, and keep the body in shape with a sense of well-being.

The aim of the present study was to assess knowledge and awareness about the prevalence of diabetes mellitus due to consumption of junk food among the general population.
 
INTRODUCTION:
Junk food is also known as fast food due its ease of making and consumption. It is also called HFSS , High fat, salt or sugar. It’s concise packing and attractive colours draw children's attention.
 
MATERIALS AND METHODS:
A cross-sectional study in the form of a survey was conducted among the parents of the victims in particular along with the general population. Through the online platform the survey was done by distributing the questionnaire. Around 100 responses were collected, data was circulated, results were collected and statistically analysed through SPSS software.

Diabetes mellitus has been described as the most common endocrine disorder that impairs glucose homeostasis resulting in severe complications. Chronic hyperglycemia in diabetic patients is associated with long term damage, dysfunction and eventually the failure of organs, especially the eyes, kidneys, nerves, heart and blood vessels.
Currently, there is a renewed interest in the plant based medicines. One such herbal drug, Aloe Vera used for different clinical purposes claimed for its effect on blood glucose levels.
Total of 240 type 2 diabetes mellitus patients were enrolled and allocated to four groups viz. A, B, C and D. Group A and C will be given conventional anti-diabetic agents, however Group B and D in addition to anti-diabetic agent, Aloe Vera will be given as add on therapy.
While assessing the results and comparing the overall degree of glycaemia control between group A & B, a significant (p<0.004) difference with mean fasting and mean PP blood glucose (p<0.001) were observed. Similarly comparing the overall degree of glycaemia control between group C & D, a significant (p<0.004) difference with mean fasting and mean PP blood glucose (p<0.000) were observed. A significant difference between mean HbA1c recorded before and after the treatment in the groups were treated with Aloe Vera as add on therapy with conventional antidiabetic drugs.
The study concluded that the subjects who were treated with Aloe Vera as an add on therapy with conventional antidiabetic drugs has comparatively produced better clinical outcome in terms of glycaemia control and lower incidence of complications.

Obesity is a major risk factor for Diabetes Mellitus(DM). Older anthropometric measurements like Body Mass Index(BMI), Waist Circumference(WC), Waist Circumference Height ratio(WHt ratio) etc and newer ones like A Body Shape Index(ABSI) and Body Roundness Index(BRI) are used to detect obesity. This study was undertaken to determine the utility of newer and older anthropometric measurements in predicting the risk of DM among urban population of Mandya city.
Methods: Fasting Blood Sugar(FBS) and anthropometric measurements like BMI, WC, WHt ratio, BRI and ABSI were measured. Correlation analysis, Odds Ratio and ROC curves were analyzed to know the ability of each anthropometric measurement in predicting the risk of DM.
Results: Overall prevalence of DM in the study population was 23.4%. All anthropometric measurements except ABSI were significantly high in subjects with DM. According to OR value, WHt ratio(2.254) was the best predictor of DM, followed by BMI(Asia Pacific classification) with 2.16.Older anthropometric measurements such as BMI(r=0.252;p=0.000*), WC(r=0.230;p=0.000) showed a significantly positive correlation with FBS compared to BRI and ABSI. According to ROC curves, the highest AUC was found with older methods such as WC(0.617) and BMI(0.616) followed by WHt ratio(0.595) and newer methods such as BRI(0.595) and ABSI(0.542).
Conclusion: Older anthropometric measurements have better discriminatory powers and significant strength of association with DM compared to newer ones. Establishing newer reference ranges of FBS for Asian population and incorporation of Asia Pacific Guidelines of BMI classification at all levels of health care in India is needed for better risk stratification and the prevention of DM.

Aims and objectives: The present study was conducted to study the prevalence of anemia in mild, moderate and severe degrees of hyperglycemia in type II Diabetes Mellitus, to study the Association of CRP with levels of HbA1c in type II Diabetes Mellitus, to study the Association of CRP with degree of Anemia and to compare the hematological parameters (Hb%, MCV, CRP) among the patients of type 2 diabetes mellitus with HbA1c levels below 6.5% and above 6.5%.
Results: Mild anemia was 57%, moderate anemia was 31% and severe anemia was 12%. Higher infection (>6) CRP has higher HbA1c (15) level and was statistically significant. Comparison of anemia with CRP and HBA1C were showed statistically significant results. Hematological parameters (Hb%, MCV, CRP) were statistically significant among the patients of type 2 diabetes mellitus with HbA1c levels. Lower HbA1c level (<6.5) was showed higher Hematological levels. (Hb%, MCV, CRP)
Conclusion: Prevalence of anemia was found significant with increasing severity of hyperglycemia and higher incidence of anemia is likely to occur in patients with poorly controlled diabetes. Our study indicates lower levels of CRP can be achieved with better glycemic control. Further good glycemic control in diabetes mellitus is associated with better hemoglobin levels and a lesser incidence of anemia

Background: There is an increase in incidence of tuberculosis (TB) despite successful implementation of directly observed treatment, short course (DOTS) in India. The burden of diabetes and tuberculosis is more in developing countries and these diseases often coexist. Suboptimal control of diabetes predisposes the patient to tuberculosis and is one of the common causes of poor response to anti-tubercular treatment.
Objective: To study the efficacy of DOTS therapy in newly diagnosed patients of pulmonary tuberculosis with and without associated diabetes.
Methods: The prospective study was conducted at the department of General Medicine, in Mahatma Gandhi Medical College and Hospital Jaipur a tertiary health care centre in Rajasthan. In the study patients were grouped into one having PTB with DM and other group PTB without DM. Informed written consent was obtained from all patients and their clinical features were recorded. DOTS treatment was initiated and patient were followed up monthly for sputum conversion and weight gain.
Results: A total of 60 patients (20 to >60 years) were enrolled in the study with equal numbers being grouped in the 2 categories i.e. PTB with DM and PTB-non DM. More sputum positivity 21(70%) was associated with diabetic group. Sputum conversion were seen in 3 patients in diabetic group whereas it is seen in 1 patient in non-diabetic group in 2-3 months. Average weight gain is more in non-diabetic as compared to diabetic patients.
Conclusions: Good glycaemic control is needed for effectiveness of DOTS therapy. Early screening and diagnosis of Diabetes in patients of pulmonary tuberculosis will definitely help in management of both the disease.

Background: Occurrence and risk of tuberculosis is more among diabetes mellitus patients in relation to non-diabetic patients due to weakened immune system. As a result, affected patients have difficulty in responding to any kind of treatment when compared to healthy individuals.
Objective: To study the clinical and radiological profile of pulmonary tuberculosis among diabetic and non-diabetic patients.
Methods: The prospective study was conducted at the department of General Medicine, in Mahatma Gandhi Medical College and Hospital Jaipur a tertiary health care centre in Rajasthan. In the study patients were grouped into one having PTB with DM and other group PTB without DM. Informed written consent was obtained from all patients and their clinical, radiological features were recorded.
Results: A total of 60 patients (20 to >60 years) were enrolled in the study with equal numbers being grouped in the 2 categories. In our study majority of diabetic patients are males with more occurrence in >30 yrs age group having more sputum positivity with consolidation as major findings
Conclusions: Diabetes is a well-known risk factor for pulmonary tuberculosis. All patients of pulmonary tuberculosis should be screened for Diabetes especially above 30 years age group and early and prompt treatment should be started.

Objective: To estimate the proportion of diabetic retinopathy in newly diagnosed type 2 diabetes mellitus patients attending tertiary care centre at Tripura Medical College, Agartala.
Methods: The current study was a cross-sectional investigation conducted at the Tripura Medical College, Department of Ophthalmology. The study population included adults over the age of 18 with newly diagnosed type 2 diabetes mellitus (less than 6 months after diagnosis) between April 2021 and October 2022. Each patient had a thorough eye examination.
Results: 130 patients participated in the study, with a mean age of 43.2 ± 10.2 years and a 66.9% male patient population. Diabetic retinopathy was discovered in 11.5% (95% CI 14.7, 15.3) ofnewly diagnosed type 2 diabetes mellitus patients.
Conclusion: In this study, patient with newly discovered type 2 diabetes mellitus had a significant prevalence of retinopathy. This emphasises the significance of conducting a thorough ocular examination on all type 2 diabetes mellitus patients at the time of diagnosis.

Background: Acute exacerbation chronic obstructive pulmonary disease (AECOPD) is the leading morbidity and mortality cause worldwide. Many studies showed the association of hyperglycaemia with poor results from a wide range of acute illnesses.
 Aim and Objectives: To investigate the association between concentrations of blood glucose & clinical outcomes in AECOPD patients admitted to the hospital.
Material and Methods: This is a hospital-based retrospective analysis carried out on AECOPD patients admitted during the period of January 2021 to March 2022. Detailed history, clinical examination, blood investigations were performed. Random blood glucose levels at the admission were noted, and the subjects were separated into groups of four on the basis of blood glucose levels (≤ 140 mg/dl, 141- 170 mg/dl, 171-200 mg/dl, >200 mg/dl). The clinical outcome was compared among these four groups.
Results: In this study majority were male patients (86%) with age ranging from 66-75 years (46%). About 85% of patients were smokers, and 15% were non-smokers. 68% of the study group population was hyperglycaemic (RBS >140 mg/dl). Among different quartiles, the mean length of stay in hospital was statistically considerable (p=<0.05), signifying an increased length of stay in hospital trend as the admission RBS levels increase. There was no statistically significant relationship amongst the RBS quartiles of ≤140 mg/dl and RBS quartiles of 141-170mg/dl (p=0.997). There was a statistically considerable correlation amongst the RBS quartiles ≤140 mg/dl and RBS quartiles ≥201 mg/dl(p=000), and this study’s crude rate of mortality was 5%. The population under quartile of RBS ≥201mg/dl had the highest percentage. All the people who died were over the age of 56 years. The mean HbA1c among dead (9.43 ± 2.25) and alive (6.78±1.70) showed significant relation (p=<0.05).
Conclusion: Higher the admission RBS, longer was the mean length of stay in hospital and mortality in the AECOPD diagnosed patients. Maintaining the blood glucose levels < 170 mg/dl than the strict glycaemic control, i.e.<140 mg/dl, could benefit these patients' outcome. This study indicates that for clinically treating the AECOPD patient population, targeted surveillance, as well as DM management, are critical.

Background:Diabetes Mellitus is a chronic condition caused by insufficient insulin production or insulin resistance, as well as excessive or insufficient glucagon production. Hyperglycemia is a consequence of untreated diabetes that causes harm to multiple body systems through microvascular, macrovascular, and neuropathic problems over time. In addition, testosterone levels were shown to be low in uncontrolled type 2 diabetic patients.
Aim and objectives: To investigate the incidence of low testosterone levels in men with type 2 diabetes, as well as the prevalence of erectile dysfunction in men with type 2 diabetes and its impact on everyday activities.
Methods: This research was conducted out in the Department of Medicine of Maharishi Markandeshwar College and Hospital, Solan. A total of 100 men with type 2 diabetes were studied to determine the prevalence of low testosterone levels.
Results: This study enlisted 100 type 2 diabetes patients over the age of 40 to look at serum testosterone levels. In 69 patients with HbA1C levels greater than 7.5%, testosterone levels were found to be low. In low testosterone groups, erectile dysfunction was reported. The relationship between type 2 diabetes and hypogonadism has been examined extensively in many research, however whether DM therapy can treat hypogonadism or testosterone can enhance glycemic control in diabetic patients with hypogonadism is still debatable.
Conclusions: Due to the high prevalence of both low testosterone levels and ED, all diabetic male patients over the age of 40 should be screened

Background: Cardiovascular disease (CVD) is the primary cause of mortality and morbidity in patients with type 2 diabetes mellitus. The present study was conducted to assess association of serum uric acid with albuminuria and carotid atherosclerosis in type 2 diabetes mellitus patients.
Materials & Methods: 65 type II diabetes mellitus patients of both genders were included. In all, uric acid (UA) was measured by enzymatic photometric test, urine albumin was measured by immunoturbidimetric assay, urine creatinine was measured using creatinine Jaffe method and albumin creatinine ratio (ACR) was calculated by dividing urine albumin concentration with urine creatinine concentration.
Results: Out of 65 patients, males were 35 and females were 30. The mean uric acid in males was 6.82 mg/dl and in females was 5.16 mg/dl.Albumin showed normoalbuminuria in 30, micromoalbuminuria in 20 and macromoalbuminuria in 15. IMT was between 0.4-0.5 cm       in 12, 0.5- 0.6 cm in 14, 0.6-0.7 cm in 20 and 0.7-0.8 cm in 9 subjects. The difference was significant (P< 0.05). UA had positive correlation with logarithm of urine albumin excretion and IMT (P< 0.05).
Conclusion: Asymptomatic hyperuricemia is highly prevalent in type 2 diabetic patients. Serum UA concentration serves as early and independent marker of renal dysfunction in type 2 diabetic patients. Serum UA concentration serves as early marker of carotid atherosclerosis in type 2 diabetic patients.

Aim: The aim of the present study was to evaluate the role of utility of Red Blood Cell count, Red Cell Distribution Width, and Neutrophil/Lymphocyte Ratio as prognostic markers in type 2 Diabetes Mellitus patients with and without microvascular complications.
Methods: The present study is a cross-sectional analytical study. It was undertaken in the Department of Medicine of the parent institute Dr D.Y Patil Medical College, Hospital and Research Centre, Pimpri, Pune, during the period of October 2020 to September 2022 with the aim to evaluate the role of utility of Red Blood Cell count, Red Cell Distribution Width, and Neutrophil/Lymphocyte Ratio as prognostic markers in type 2 Diabetes Mellitus patients with and without microvascular complications.
A total of 300 patients were included in the study- 150 cases, with microvascular complications, and 150 controls, without microvascular complications.
Results: It was evident from the results that majority of patients were in the 51- 60 age group (29%) followed by 61-70years (25%) and 71-80years of age (20%).

Type 2 DM hyperthyroidism is reported to be more common as compared to normal people. In many patients, uncontrolled hyperthyroidism may be the reason for poor glycemic control and recurrent diabetic ketoacidosis. In response to hyperthyroidism gut absorption of glucose is increased along with endogenous glucose production. Randomly selected 100 patients, both male and female with type 2 diabetes mellitus above age of 40 years including newly diagnosed diabetics attending hospital were included in this study. Among the study group of 100 patients 2 patients had high T4 value, 8 patients had high TSH values and 4 patients were low TSH values.

Diabetes mellitus (DM) is defined as a chronic and metabolic disorder. It was approximated about 77 million Indians suffer from DM and it will be increased to 134 million by 2045. Diabetic mellitus can be treated by close control of glucose level which is main aim and target in management of this condition. Management of DM can be done by non-pharmacological and pharmacological approaches. The aim of this study is to compare the safety, efficacy and cost effectiveness of Glipizide-Metformin and Glimepiride-Metformin combination therapy in type 2 diabetes mellitus. In current research by use of prospective method in the cardiology department of Kongunad Multi-speciality Hospital, Coimbatore, in a period of six months from February 2021 to August 2021 we did research according to our aim and used ANOVA statistical test whenever it needed. Our study results demonstrate, the improvement in the addition of glimipride 2mg to metformin 500 mg has modest beneficial then glipizide 5 mg in terms of efficacy and cost. In terms of safety, both drugs are having similar safety profiles. Current research also assessed the medication safety by using the Naranjo scale

Background: Diabetes mellitus (DM) has become a major and serious threat to global human health. The present study assessed high-sensitivity C-reactive protein, malondialdehyde and their association with glycated hemoglobin in type II diabetes patients.
Materials & Methods: Group I comprised of 96 type II diabetics and group II had 96 healthy control subjects. HbA1c, serum insulin, hs- CRP, Homeostasis model assessment for insulin resistance, serum creatinine and malondialdehyde (MDA) levels were measured.
Results: Group I had 56 males and 40 females and group II had 48 males and 48 females. HOMA- IR was 4.8 in group I and 1.7 in group II, MDA level in group I was 5.07 µmol/L and in group II was 1.31 µmol/L. Creatinine level was 0.98 mg/L in group I and 0.85 mg/L in group II, cystatin C was 0.85 mg/L in group I and 0.92 mg/L in group II. The mean Hs-CRP (mg/L) level was 4.6 in group I and 1.9 in group II. The difference was significant (P< 0.05).
Conclusion: Type II diabetes mellitus patients had elevated level of malondialdehyde and high-sensitivity C-reactive protein as compared to healthy control subjects

Background : Diabetic foot problems are a major cause of morbidity and premature mortality in people with diabetes. Objectives: The aim of the study was to explore the perceived barriers in foot care and to assess the foot care practice among diabetic patients undergoing treatment at a selected hospital in Karad with a view to conduct a demonstration program on foot care. Methods: Research design adopted for the study was a descriptive exploratory survey. Purposive sampling technique was used to select 120 diabetic patients. Structured interview schedule was used to explore perceived barriers of foot care and foot care practice. Demonstration program on foot care was conducted for all patients. Results: Majority (77.5%) of the diabetic patients were having poor practice regarding foot care and only 22.5% were having good practice. Subjects expressed many barriers which have interfered with their regular practice of foot care. Conclusion: Majority of diabetic patients had poor foot care practice and the patients expressed many barriers that had an influence on their foot care practice. Findings stress the need for educational and motivational strategies for diabetic patients to comply with effective foot care.

Background: Diabetes Mellitus is an important health problem affecting major populations worldwide. The purpose of this study was to find out how well the thyroid works in people with type 2 diabetes mellitus with or without nephropathy.
Materials and Methods: Group I did not have any diabetic nephropathy patients, and Group II did not have any diabetic nephropathy patients. All patients were subjected to a detailed history and clinical examination,
Moreover, 5 ml of venous blood was drawn by aseptic technique and various lab investigations, such as thyroid function tests, were done.
Results: Group I had 16 males and 14 females, and Group II had 15 males and 15 females. Thyroid function in group I and group II was normal in 21 and 15, low T3 syndrome in 5 and 6, subclinical hypothyroidism in 3 and 5, and overt hypothyroidism in 2 and 4, respectively. The difference was significant (P< 0.05). There was a correlation of TSH with SCr, eGFR, and UACR in group II (P< 0.05).
Conclusion: Thyroid dysfunction was more prevalent in patients with diabetic nephropathy.

Background:Diabetes mellitus is a syndrome characterized by chronic hyperglycemia and the most common complications such as atherosclerosis, nerve damage, renal failure, male impotence and infection. The present study was conducted to assess total antioxidant status in relation to oxidative stress in type II diabetes.
Materials & Methods: 90 type II diabetes patients and healthy subjects of both genders were subjected to assessment of malondialdehyde levels and total antioxidant status.
Results: Group I had 50 males and 40 females and group II had 45 males and 45 females. The mean malondialdehyde (MDA) level in group I was 3.68 µM and in group II was 1.90 µM. The mean total antioxidant status (TAS) in group I was 0.48 mM and in group II was 1.68 mM in group II. The difference was significant (P< 0.05).
Conclusion: Type II diabetes mellitus patients exhibited decreased TAS status and increased MDA levels. It may be considered as an early marker of the pathogenesis of complications in type 2 diabetes mellitus.

Background: Adhesive capsulitis, or "frozen shoulder," is characterised by a variety of problems experienced by the glenohumeral joint, including discomfort, stiffness, and/or a loss of function. It is one of the most disabling consequences of diabetes that affects the muscles and bones. The aim of this study to evaluate the prevalence and risk factors for frozen shoulder in diabetic patients.

Background: Diabetes mellitus is one of the most important underlying condition contributing to high morbidity and mortality globally leading to a number of cumbersome clinical conditions, of which a Diabetic Foot Ulcer ( DFU) is the most dreaded complication. A leading cause of hospitalization, in diabetic patients 36 the consequences are adverse leading to loss of a part of the lower limb or the whole limb. The risk of amputating a lower limb is 15 -46 times higher in a diabetic patient than in a non diabetic patient.
 
Aims and objectives: 1. To determine the genera of microorganisms found in diabetic foot ulcer. 2. To determine the antibiotic susceptibility pattern of organisms found in diabetic foot ulcer.
 

Background: Pulmonary hypertension is a recognised complication of chronic kidney disease, especially in end stage renal disease. It has prevalence estimates of 30-50%.  Present study aimed to study magnitude of pulmonary artery hypertension in chronic kidney disease patients
Material & Method: This observational analytical cross sectional study was conducted among the adult more than 18yrs of age with CKD attending department of general medicine. After obtaining informed and written consent from the patients, detailed history, clinical assessment and laboratory diagnosis to be done. (Blood urea, Serum creatinine, Serum uric acid, Serum electrolytes, Urine Routine, Complete hemogram, Liver function tests)
Result: The mean age of the patients was found to be 49.45±8.97yrs, with majority of the patients in age group of 41-60yrs. On gender assessment majority of the patients were male (68%), with male preponderance.  There is 18.4% of patients presented with pulmonary hypetension. There is a significant higher incidence of the pulmonary hypertension among the patients with stage 3 (30.4%) and stage 4 CKD (60.9%) patients.
Conclusion: CKD patients have a higher prevalence of pulmonary hypertension. The prevalence of pulmonary hypertension is high in stage 5 CKD patients, and it is also higher in dialysis patients. In CKD patients, there is no gender difference in the development of pulmonary hypertension.

Introduction: Nonalcoholic fatty liver disease (NAFLD) prevalence is high, especially in patients with obesity and type 2 diabetes, and is expected to rise steeply in the coming decades. Objective:  We estimated NAFLD prevalence in patients with type 2 diabetes and explored associated characteristics and outcomes.
 
Material and Method: This is a prospective and cross-sectional study was conducted in the Department of Medicine at Tertiary care Teaching Hospital over a period of 6 months. The study population comprised of male and female patients who were diagnosed as having type 2 diabetes mellitus based on their fasting and random blood sugar levels. Frequency and percentages were calculated for categorical variables like sex and non-alcoholic fatty liver diagnosed on abdominal ultrasound. Non-alcoholic fatty liver was stratified among the age, sex and duration of type-2 diabetes mellitus to see the effect modifiers.
 
Results: Out of 320 participants, 200 patients (62.5%) had NAFLD on ultrasound. A total of 320 participants were enrolled for the study, of whom there were 140 (43.75%) males and 180 (56.25%) females. The mean age and mean duration of T2DM are presented. Overall, NAFLD was present in 200 (62.5%) study participants. Moreover, patients having NAFLD were compared with patients having no ultrasonographic evidence of NAFLD. There was no statistically significant difference between the two groups regarding mean age and gender distribution. Though, there was a statistically significant difference amongst the two groups in terms of HbA1c, triglycerides, total cholesterol, LDL and HDL cholesterol and serum uric acid.
 
Conclusion: This study reported an increased frequency of NAFLD in our diabetic population and evaluated in depth the risk factors associated with NAFLD, underpinning the significance of carrying further large-scale studies to assess the effects of lifestyle modification in the form of physical activity and dietary modifications on the status of NAFLD and glycemic control. Taking in to account the results of this study, patients and their treating physicians should emphasize on the modification of the associated factors and it is also advisable to screen diabetic patients for this condition in routine clinical practice. Early detection and timely management will help promote healthy lifestyle and prevent long term complications of the condition

Background: Diabetes mellitus (DM) is a chronic, debilitating disease constitutes a global health threat and burden, especially in developing countries. The objective of the study was to assess the prevalence of diabetes mellitus type-2 and its associated risk factors.

Objective: There is evidence that patients with diabetes have an increased risk of asymptomatic bacteriuria and urinary tract infections (UTIs).  The aim of this study was to detect the prevalence of UTIs among diabetic patients admitted in the hospital  and  to identify the most frequent bacteria responsible for UTI:
Material and methods: The study population included 570 diabetic patients suggestive of UTI (847 women and 623 men), from Maharani Laxmi Bai medical college, Jhansi between December2018 to August 2020 . We collected patients’ personal history data and performed urine cultures.  Result: Total number of patients, 158 had urine cultures positive, meaning 10.7%. Out of the total number of 158 UTIs, 124 (78.4%) were asymptomatic bacteriuria. The most frequent bacteria involved in Urinary tract infection was Escherichia coli (68.9%). Conclusion: Infection of UTI are frequent in diabetic patients Because of the great proportion of asymptomatic forms among diabetic patients, the  culture should be performed in all hospitalized admitted patients with diabetes..

Background and Objective
Coronaviruses are a family of viruses that can cause respiratory illness in humans. They are called “corona” because of crown-like spikes on the surface of the virus. Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and the common cold are examples of coronaviruses that cause illness in humans.
The primary mode of transmission of SARS-CoV-2 is via exposure to respiratory droplets carrying the infectious virus from close contact or droplet transmission from pre-symptomatic, asymptomatic, or symptomatic individuals harbouring the virus
This study is conducted to analyse the extent of association between COVID-19 & Diabetes Mellitus and its correlation with the inflammatory markers as it is still unclear if diabetes interferes in the prognosis of COVID-19
Material & Methods
A Cross-sectional study was conducted over a period of 6 months from April 2021–September 2021.Among 149 RT-PCR positive COVID-19 patients the random blood sugar levels, CT chest severity score & C-Reactive Protein was compared among the diabetic & non-diabetic population in ACS Medical college & hospital Chennai.
Results
The study shows that out of 149 COVID-19 positive patients, 88 (59.1%) were diabetic & 61 (40.9%) were non-diabetic. Patients with diabetes had significantly higher CT chest severity score and elevated C-reactive protein than non-diabetic patients.
Conclusion
The interaction between covid-19 & diabetes could be bi-directional, with SARS-CoV-2 potentially worsening pre-existing diabetes.

Background: Diabetes mellitus, a common somatic ailment that can have psychological ramifications, is caused when insulin does not operate as well as it should. Diabetes is caused by insulin not working as effectively as it should. It is gradually gaining a reputation as a possible epidemic on a scale that encompasses the entire of the world.

Introduction: Asymptomatic bladder infection that is detected by a positive urine culture is also common among diabetes mellitus patient which progress to symptomatic infection and subsequent complication. Therefore, it becomes essential to screen urinary tract infection in diabetes mellitus patient so that its progress to complication can be prevented. Hence present study has been designated to know the prevalence of asymptomatic bacteriuria among females affected with diabetes mellitus.

Aim: To assess the gallbladder volume in T2DM patients and in healthy controls by using Ultrasonography.
Methodology: This cases control study was conducted among 55 diabetic patients enrolled from the diabetes clinic of the RVM Institute of Medical Sciences & Research Centre, Laxmakkapally, Telangana, India and 55 healthy patients (control group). 30-60 year patients of type 2 diabetes mellitus diagnosed since 5 year or more and functioning gall bladder with well controlled blood sugar levels. The diagnosis of diabetes in these patients was in accordance with WHO criteria i.e., fasting plasma glucose level ≥126 mg/dl, and ≥200 mg/dl plasma glucose level after 2hr of ingestion of standardised 75 gm glucose. An informed consent was taken from all the subjects in the study and control groups. All the patients were randomly selected for the study among patients regularly attending diabetic clinic of this hospital and following our criteria’s of selection.
Results: Mean age of diabetic Patient was 48.5 years in study group and 53 years in control group. 45.5% of diabetics were males and remaining 54.5% were females, whereas in control group male to female ratio was equal, means 49% males and 50% females. 85.5% cases in control group had no gall bladder disease, while only 63.6% cases in group with diabetes had no gall bladder disease. In group with DM type 2, 20% had cholelithiasis, 9.1% had cholecystitis, and 7.3% had sludge: while in control group, 5.5% had cholelithiasis, 3.6% had cholecystitis, and 5.5% had sludge. The percentage of contraction of gall bladder had reduced markedly in chronic diabetics (45.6 + 9.57) as compared to controls (65.2 + 7.34) (p value- 0.001). The fasting gall bladder volume in chronic diabetics was higher (43.47 + 5.35) than that of controls (28.45 + 4.26) and the difference of values was found to be highly significant (p value 0.001).
Conclusion: In patients of diabetes mellitus type 2, higher fasting gall bladder volume and decreased percentage of contraction are observed. Therefore, all T2DM patients should be evaluated using ultrasonography for the presence of increased fasting gallbladder volumes to assess the risk of progression to gall stone disease.

Background: The term "obesity" refers to an abnormal expansion of the adipose tissue that can be caused by an increase in the number of fat cells (hyperplastic obesity), an increase in the size of the fat cells themselves (hypertrophic obesity), or a combination of both of these factors. The body mass index (BMI) is frequently used as a measurement of obesity.

Background:SGLT2 inhibitor treatment has been shown to have additional benefits
such as weight loss, renoprotective and cardioprotective effects. The present study was
conducted to assess role of SGLT2 inhibitors in elderly obese uncomplicated DM
patients.
Materials & Methods:84type II DM patients of both genders were prescribed
empagliflozin or dapagliflozin. FBG, PPBG, HbA1c, liverenzymes and kidney function
tests, complete urinalysis,serum lipids, protein excretion in spot urine were
recordedbefore and after the initiation of SGLT2 inhibitor.
Results: Out of 84 patients, males were 50 and 34 were females. SGLT2 inhibitor used
wereEmpagliflozin in 40 and Dapagliflozin in 44. Comorbidities were hyperlipidemia in
57, hypertension in 62, CAD in 12 and heart failure in 7 patients. Complications were
diabetic nephropathy in 15, diabetic retinopathy in 10 and diabetic neuropathy in 22
patients. The difference was significant (P< 0.05). Laboratory findings before and after
treatment in FBG (mg/dl) was 198.2 and 154.3, PPBG (mg/dl) was 276.2 and 235.9,
HbA1c (%) was 9.5 and 7.1, hemoglobin (g/dl) was 13.5 and 14.2, hematocrit (%) was
43.2 and 45.0, urea (mg/dl) was 36.4 and 38.7, creatinine (mg/dl) was 0.8 and 0.9 and
eGFR (mL/min/1.73 m2) was 84.2 and 79.5 respectively. The difference was significant
(P< 0.05).
Conclusion: Glycemic control was successfully achieved with SGLT2 inhibitor
treatment in type II DM patients.

Introduction: Diabetes Mellitus (DM) has been progressively growing in prevalence over time, with overall annualised incidence rates per 1000 people rising from 3.0 in the 1970s to 5.5 in the first decade of the 2000s. This alteration resulted in an 83.3 percent rise in the incidence of T2DM, which was higher among males when compared with females.
Materials and Methods: This a prospective observational study undertaken at a rural tertiary care setting where two patient cohorts are made, one with diabetic patients and other with non-diabetic age and gender matched individuals. The study population (Cohort A) consisted of patients with type 2 diabetes attending the Medicine and Cardiology departments from January 2019 to February 2020. The Cohort B included age and gender matched non-diabetic individuals who are the relatives and attending staff of the patients and the working staff of the hospital.
Results and Discussion: HbA1c levels of 6.5 percent or higher in diabetics were linked to an elevated risk of cardiovascular disease. Glycosylation of haemoglobin may also affect RBC membrane lipid protein interactions, increasing internal viscosity, altering the viscoelastic properties of erythrocyte membranes and lowering RBC deformability.
Conclusion: HbA1c may be a valid predictor of cardiovascular mortality and morbidity in diabetics. The data of our study suggest that the healthcare professionals must appraise the values of HbA1c in assessing the cardiovascular risks and outcomes in the diabetes patients.

Diabetes mellitus is a public health problem in developing and developed world .The great attention was centered on the diabetic complications like cardiovascular, nephropathy, retinopathy and neuropathy. The pulmonary complications of type-2 diabetes mellitus have been poorly characterized. Several studies are suggested that diabetes is associated with impaired pulmonary functions. The underlying mechanism seems to be microangiopathy brought in by the non enzymatic glycosylation of various scleroproteins in lungs and elsewhere. Since collagen is the most abundant tissue protein in major bronchi, vessels and interstitium, the alterations in pulmonary functions occur as a rule. The aim of the present study is to assess the effects of chronic hyperglycaemia on lung functions, which focused on mechanical aspects of lung dysfunction – maximal forced spirometric pulmonary function tests like FVC, FEV1, PEFR, FEV1/FVC% to be specific.

Background: Coronavirus disease 2019 (COVID-19) is a new respiratory infection caused by a coronavirus known as SARS coronavirus 2. (SARS- CoV-2). The virus is a member of the coronavirus family, which are zoonotic pathogens that cause and transmit infections between humans and various animals. The World Health Organization (WHO) has designated coronavirus disease 2019 (COVID-19) a pandemic, with 20% of infected individuals requiring hospitalisation and 6% requiring critical care and invasive ventilatory support. Co-morbidities are thought to be a greater risk for reducing the survival probability of SARS-CoV-2 patients. Different types of pre- existing diseases have been identified as co-morbidities in SARS-CoV-2 infection, which increases susceptibility and poses risks of more severe outcomes and deaths in COVID-19 patients.Thisstudy is to identify different co-morbidities of the patients who died due to COVID-19 admitted in GMERS medical college and general hospital in city Gandhinagar in Gujarat state.
Methods:This is a retrospective study of patients admitted to covid hospital, GMERS medical college and hospital, Gandhinagar who had been reported positive either with RT-PCR Test or rapid antigen test and died in hospital during the period of April 2020 to April 2021.
Results: In present study, majority (62.9%) of the study participants were in the age group of 51 to 70 years. The mean age of the study participants was61.91 years.58.4% of the COVID-19 patients were males while 41.6% were females. 93.2% of the COVID-19 patients were having any comorbidity while among 6.8% of the patients were without any comorbidities withhypertension was most common(57.5%) followed by diabetes(53.4%). 44.8% of the study patientswere having only single comorbidity while 55.2% were having more than or equals to two comorbidities. The mean interval between hospital admission and death of the patients was 4.5 days.
Conclusion: It has been concluded that old age, male gender has more severe outcome in case of COVID-19. Hypertension and diabetes mellitus were also reported among more than 50% of the patients who died from COVID-19.

Background: Diabetes-related consequences, including microvascular and macrovascular, pose a significant burden in India. Diabetes mellitus (DM) is becoming more common, resulting in an increase in the number of people suffering from DM complications. Diabetic peripheral neuropathy (DPN) is the most prevalent complication among DM patients, affecting 18.8 to 61.9 percent of those in India. DPN problems can be reduced if diagnosed early. Screening programmes at the primary care level can aid in the early detection of problems and improve health outcomes in diabetic patients. The purpose of this research was to determine risk factors for peripheral neuropathy in newly diagnosed Type 2 diabetic patients in Cuttack, Odisha.
Methods: This was part of a cross-sectional study to determine the prevalence of peripheral neuropathy among newly diagnosed T2DM patients attending the Cuttack Primary Care Clinic in Odisha. It included a total of 254 patients. A set of case report forms containing sociodemographic data, clinical examination results, and investigation findings was used. Diabetic peripheral neuropathy exists when the patient is unable to feel the monofilament 5.07 (10g) at one or more of the sites examined.
Results: The participants' mean (SD) age was 53.3 (9.06) years. Peripheral neuropathy was found in 8.7 percent of the individuals. Age (p 0.001) and the existence of retinopathy (p = 0.001) were factors that contributed to the development of peripheral neuropathy in newly diagnosed type 2 diabetes patients.
Conclusion: All T2DM patients should be tested for peripheral neuropathy at the time of diagnosis so that preventive interventions can be implemented to prevent diabetic foot disease. Patients with retinopathy should be tested for neuropathy as well.

Background and objectives:  During the second wave of corona virus pandemic, we saw an increase in the case reports of rhino-orbital mucormycosis in patients with coronavirus disease (COVID -19) or in patients who had recovered from COVID -19 infection. We evaluated the patient characteristics and predisposing factors in these patients having mucormycosis.
Materials and method: This retrospective observational study included 84 patients with mucormycosis diagnosed during their course of COVID-19 illness between May 2021 to July 2021.Data regarding demography, underlying medical condition, extent of involvement of mucormycosis, COVID-19 status and treatment taken during COVID-19 illness were collected.
Results: Eighty-four patients presented with mucormycosis out of which 59 patients were males and 25 females. Majority were in the age group of 40-60 years (71.4%). Rhino-orbital was the most common form of mucormycosis. Intracranial spread was noted in 16 patients. Hyperglycemia at presentation (either pre-existing or new onset diabetes mellitus) was the single most important risk factor observed in majority of these cases (80 patients / 95.23%) followed by history of Corticosteroid use in 68 patients (80.95%) and oxygen administration during their course of treatment for COVID-19 illness in 64 patients. (76.19%)
Conclusion:The association between coronavirus and mucormycosis must be given serious consideration. Uncontrolled diabetes and over-zealous use of corticosteroids are the two most important factors aggravating the illness. All efforts must be made to maintain optimal glucose levels in COVID-19 patients and use corticosteroids judiciously.

Background: Diabetes mellitus type 2 (DMT2) is one of the most prevalent endocrine
illnesses, affecting about 135 million individuals globally. The disease's genesis is
unknown, but subclinical hemochromatosis has recently been identified as one of the
possible causes of DM. The purpose of this study was to look at the association between
serum ferritin as a measure of iron excess and diabetes and HbA1c.
Methods: This 12-month study was carried out in the Medicine department of Katihar
Medical College Hospital in Bihar, India. 46 patients with T2DM were used as cases in
this case control study. The control group consisted of 46 healthy individuals who were
age, gender, BMI, and haemoglobin percent matched to the case group. Blood samples
were tested for ferritin, haemoglobin, HbA1c, and fasting plasma sugar. Anaemia and
any other ailment or medicine that could alter ferritin levels were exclusion criteria.
Result: The Pearson correlation coefficient test, Student's t-test, Chi-square test, and
Odds ratio were used to assess the results statistically. Diabetics had considerably
higher mean serum ferritin levels than the control group (197.97± 75.99 gm/L vs. 64.24±
27.83 gm/L, p<0.001). In diabetic patients, there was a substantial positive connection
between HbA1c and serum ferritin (p<0.001). In this investigation, an OR of 11.64 was
also discovered.
Conclusion: Serum ferritin levels are associated with T2DM patients. This could be a
significant and independent predictor of the development of diabetes mellitus

Background: Type 2 diabetes mellitus (DM2) is an important health problem worldwide affecting about 8 percent of population. The present study was conducted to assess correlation of serum ferritin with HbA1c in type 2 diabetic patients.
Materials & Methods: 74 type II diabetes patients of both genders were put in group I and age matched control in group II. Parameters such as Hb%, Ferritin, hemoglobin, HbA1c and fasting plasma sugar were measured in blood samples. The blood sugar was measured after 12 hours of fasting by glucose oxidase method.
Results: Out of 74 patients, males were 44 and females were 30. The mean BMI in group I was 27.3 kg/m² and in group II was 27.1 kg/m². FPG was 7.4 mmol/L in group I and 5.8 mmol/L in group II. The mean HbA1c level was 8.7% in group I and 5.2% in group II. The mean S. ferritin level in group I was 198.3 µgm/L in group I and 64.8 µgm/L in group II. The difference was significant (P< 0.05). There were 28 subjects with HbA1c level <6% and serum ferritin level <150 µgm/L and 9 subjects with >15 µgm/L. There were 13 subjects with HbA1c level >6.1% with serum ferritin level <150 µgm/L and 24 with serum ferritin level >150 µgm/L. The difference was significant (P< 0.05). OR of 11.7in subjects with higher serum ferritin level are in 11.7 times at risk to develop type II DM thanthose with lower serum ferritin level.
Conclusion: There was significant increase in serum ferritin in diabetes mellitus compared to control group. Positive correlation between HbA1c and serum ferritin has also been found.

Background:The relationship between sensorineural hearing loss (SNHL) and Diabetes mellitus has been known age ago. The pathophysiology of diabetes related hearing loss is speculative. Hearing loss is usually, bilateral, gradual onset, affecting higher frequencies.
Aim: To find the prevalence of Sensorineural Hearing Loss in Type 2 Diabetes Mellitus patients.
Materials and methods:This is a cross-sectional study, which included 140 diabetics of age group 30 to 50 as cases. All the subjects were subjected to the estimation of FBS, PPBS, HbA1c and pure tone audiometry. Various biochemical and audiological investigations have revealed that there is a strong association with sensorineural hearing loss and Diabetes Mellitus.
Results:The prevalence of sensorineural hearing loss in type II diabetics has been proved to be 66.43%. In the majority of the patients the hearing loss was bilateral progressive and symmetrical affecting higher frequencies of 4 KHz to 8KHz. It was seen that 93 diabetics had sensorineural hearing loss out of which 2 of them had sudden onset hearing loss. Rest of them had progressive hearing loss. The occurrence of hearing loss was matched for age, sex, duration of diabetes, and control of diabetes. It had positive correlation with increased age of the patient and duration of diabetes. There was no significant difference in hearing loss among the two sex groups.
Conclusion:The control of diabetes was measured with glycated hemoglobin which had a correlation with hearing deficit. Patients with poor control (HbA1c greater than 8%) of their glycemic status have increased auditory thresholds.

Background:Diabetes in Pregnancy Study Group India (DIPSI) and International
Association of Diabetes and Pregnancy Study Groups (IADPSG) recommendations are
general diagnostic criteria utilized in our country for determining gestational diabetes
mellitus (GDM). To diagnosis GDM, the IADPSG following Hyperglycaemia and Adverse
Pregnancy Outcome (HAPO) recommends fasting plasma glucose (FPG) of 92 mg/dL, 1-h
PG of 180 mg/dL, or 2-h PG of 153 mg/dL.
Aims:To compare DIPSI recommended GTT and IADPSG-2 phase strategy in terms of
efficacy for diagnosing GDM.
Materials and methods:The study was undertaken on antenatal women in the Out Patient
Department of our hospital. It was done to compare the efficacy of DIPSI recommended GTT
and IADPSG2-phasestrategyin diagnosing GDM and also to study the neonates of the two
groups in terms birth weight, presence of neonatal hyperbilirubinemia and presence of any
respiratory distress.
Results:The data from 70 women in groups A and B was analysed. There is no statistically
significant difference in the demographic distribution of the study groups. The number of
GDM cases detected by the two diagnostic criteria did not differ significantly. When
comparing the two groups, birth weight, respiratory distress, and neonatal hyperbilirubinemia
are all negligible. When comparing groups, the type of labour and delivery are unimportant.
In both study groups, there is no significant difference in the frequency of GDM patients who
require either MNT or insulin +MNT.
Conclusions:We conclude that application of DIPSIGTT is comparable to the new IADPSG
guidelines recommended by ADA in the diagnosis of GDM Even those who came under lowrisk
category for developing GDM according to ADA were found to develop GDM in the
study population in both the groups.

Background:Urinary tract infections (UTI) are among most prevalent illnesses seen in diabetics. To reduce the morbidity of symptomatic infection, early diagnosis and treatment is indicated. This study was done to assess the prevalence of UTI in diabetics, responsible organism & antibiotic sensitivity.
Materials and Methods: A total of 100 diabetics >18 years of age reporting to department of Microbiology were studied. Urine examination was done for isolation and antibiotic sensitivity testing.
Results: Prevalence of UTI was 39 %. E. coli followed by Enterococcus and Klebsiellaspp were most commonly isolated. These were sensitive to amikacin, imipenem and linezolid.
Conclusion: Isolation and antimicrobial sensitivity testing of uropathogens is vital in diabetics with UTI.

Aims: To compare HbA1c levels with inflammatory markers that include a neutrophilto-
lymphocyte ratio (NLR) and monocyteto-lymphocyte ratio (MLR) in controlled and
uncontrolled diabetics.
Materials and methods: Two hundred type 2 diabetes mellitus (T2DM) patients were
separated into two groups of managed (HbA1c 7%) diabetics. HbA1c (glycated
haemoglobin) levels, leukocyte count (WBC), haemoglobin (Hb), hematocrit (Hct), red
blood cell distribution width (RDW), neutrophils, lymphocytes, and monocytes were all
measured using recent laboratory data. The laboratory results were used to determine
the NLR and MLR.
Results:Controlled diabetics had a mean age of 58.30 years, while uncontrolled diabetics
had a mean age of 55.62 years. The mean NLR in diabetics with and without diabetes
was 2.61 and 4.88, respectively. The distinction was discovered to be statistically
significant (p < 0.05). The mean MLR in diabetics with and without diabetes was 0.2
and 0.24, respectively, however the difference was not statistically significant (p > 0.05).
The data showed a modest positive connection between HbA1c levels and the
haematological indices, but it was statistically insignificant.
Conclusion: The study found a substantial difference in NLR between diabetics who
were well-controlled and those who were not. Although only a slight positive connection
was detected between glycated Hb levels and the haematological indices, the results
revealed a substantial difference in NLR between the two groups. This demonstrates
that these ratios have the potential to be used as inflammatory indicators in T2DM.

Background:Diabetes Mellitus (DM) is a major concern in India and has been described as a modern-day epidemic. It can affect nearly every organ and cause a slew of complications. Cardiac autonomic neuropathy (CAN) is a serious complication of diabetes. It is also one of the least diagnosed and understood diabetic complications. The purpose of this study was to determine the prevalence of CAN in diabetic patients and to investigate its relationship with the duration of DM and glycemic control.
Materials and Methods: 80 diabetic patients admitted to the Department of Medicine, NRI Medical College, Guntur, met the inclusion and exclusion criteria. Demographic data, history, and clinical examination were documented. All individuals were tested for CAN using 3 tests to assess parasympathetic and 2 tests to assess sympathetic function. Patients were classed as normal, early CAN, definite CAN, or severe CAN using Ewing's criteria. The duration of time for the study was one year and eight months.
Results: The prevalence of CAN in the studied population was 60%. In individuals with CAN, the duration of diabetes was substantially longer, and HbA1c was much greater than in patients with normal cardiac autonomic function. There was a significant connection between CAN and DM duration (r=0.54435) and glycemic control as determined by HbA1c levels (r=0.665925), but not with age. The normal CAN score was 29 (36.25 percent), the early CAN score was 30, the definite CAN score was 9, and the severe CAN score was 12. (15 percent). Background retinopathy (68 percent), proliferative retinopathy (31%), and various retinopathies were identified in CAN patients (19.6 percent) Number 11 maculopathy (19.6 percent) 11. Clinical Presentation Characteristics of Patients Patients with severe CAN and impaired cardiac autonomic function developed diabetic foot 35.55 percent of the time, cataracts 57.14 percent of the time, muscle wasting 14% of the time, and tingling 90% of the time.
Conclusion: CAN is a common and widespread consequence of diabetes that is asymptomatic in the early stages. As a result, it is recommended that every diabetic patient be diagnosed for CAN.

Background:Diabetic patients might exhibit dry eye symptoms probably due to neuropathy,
metabolic dysfunction, or abnormal lacrimal secretions. The present study was conducted
to assess prevalence of dry eye diseases in diabetic patients.
Materials & Methods:92 diabetic patients of both genders were enrolled. Ocular
examinations, fasting blood sugar (FBS), postprandial blood sugar, and glycosylated
hemoglobin estimation (HbA1c) were recorded. Dry eye patient was diagnosed with the
help of slit-lamp examination, Schirmer’s test, tear film break-up time (BUT), and Rose
Bengal staining technique. Gradation of dry eye was done by the following standard
protocol.
Results: Dry eye was present in 70 and negative in 22. The mean duration of diabetes was
11.4 years in positive cases and 5.6 years in negative cases. The difference was significant
(P< 0.05).Grade was mild in 32, moderate in 20 and severe in 18 patients. The difference
was significant (P< 0.05). Age group (years)<50 years had 24, 50-60 years had 30 and >60
years comprised of 16 patients. Blood sugarcontrol (HbA1c) was good in 12, fair in 10,
action suggested in 28 and poor in 20 patients. The difference was significant (P< 0.05).
Conclusion: There was high prevalence of dry eyes in diabetic patients. Grade of dry eyes
was mild, moderate and severe.

Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance occurringfor the first time during pregnancy. The prevalence of GDM varies in direct proportion to theprevalence of Type 2 diabetes for a given ethnic group or population. It is crucial to detectwomen with GDM as the condition is associated with diverse range of adverse maternal andneonatal outcomes. This study aims at determining the incidence of insulin resistance and gestational diabetes mellitus in the antenatal population and for their maternal and foetal outcomes.
Materials& Methods: A hospital based observational prospective study done on all pregnant women attending the antenatal clinic in government district hospital, Sirohi, Rajasthan, India during one year period.Screening for Insulin Resistance was done at the time of booking or the first antenatalvisit if they met the criteria for the high risk group, by Fasting Serum Insulin and FastingPlasma Glucose levels.IR value calculated with HOMA-2IR software and value > 1.8 wastaken as cut off for insulin resistance. Patients labelled GDM were started on specifictreatment with medical nutrition therapy, oral hypoglycaemic agent and insulin therapy. Theywere then followed up till term ensuring adequate glycaemic control with 3 weeklysupervised hospitalized blood sugar profile. Maternal and foetal outcomes were there afterdocumented and studied.
Results:Our study showed that total no. of antenatal patients was 500 during one year study period and 55 (11%) patients detected insulin resistance and gestational diabetes mellitus. So, the incidence of carbohydrate intolerance was 11%.The mean age of these pregnant women was 28.56±4.23 years.Our results shows that positive statistically significant correlationbetween insulin resistance and development of glucose intolerance (p <0.0001).  The present study shows that there is no statistical significant association between development of Gestational Hypertension and Insulin Resistance (P>0.05).
Conclusion: We concluded that early detection and institution of specific treatment of glucose intolerance with MNT/ OHA/ Insulin therapy certainly gives better maternal and neonatal outcomes.The costeffectiveness and simplicity of this model of care makes it suitable for countries with highprevalence of glucose intolerance.

Introduction: Carotid intima media thickness (CIMT) is used as a indicator of atherosclerosis, whichcauses Macro-vascular diseases. with risk factors like age, HTN, Raised BMI, duration of uncontrolled DM, may actually have a correlation with CIMT either directly or indirectly influencing the disease processand causes atherosclerosis⁽¹⁾.
Materials and Methods: cross sectional study of 100 patients with type 2 DM admitted in civil hospital over a period of 1 year, age group between 35 to 75 years selected through simple random sampling. Macro vascular complications like CAD/CVD/PVD are dignosed with the help  of echocardiography, CT scan and with the help  of history and clinical examination. CIMT is measured with B mode ultrasound.
Result : 73 percent patients have macrovascular complications who have raised value of CIMT and 68 percent  patients with macrovascular diseases have raised value of CIMT.
Conclusion: increased value of CIMT in diabetic patients has more chances of macrovascular complication hence early detection of atheroscelerosis and early life style modification can prevent macro vascular complication⁽²⁾.

Background:Diabetes mellitus has been postulated to alter the morphology of the
cornea.Aim of our study was to compare the morphological characteristics of corneal
endothelial cellsin type 2 diabetic patients with age-matched healthy subjects. We also
determined the association of corneal morphological features with the general
characteristics and laboratory data of diabetic patients, including disease duration,
urine albumin creatinine ratio.
Methods:A case-control study in a tertiary care hospital of northwestern India with a
total of 50 diabetic patients and 50 healthy controls were enrolled in the study. All
participants underwent a complete ophthalmological examination. Corneal endothelial
measurements were performed using a noncontact specular microscopy. Laboratory
data including serum fasting glucose, --HbA1c levels, creatinine levels, and the urinary
albumin-to-creatinine ratio were recorded. Diabetic patients were further subdivided
into 3 groups according to the presence and stage of diabetic retinopathy. Specular
microscopy findings and central corneal thickness of all patients were compared.
Results: The ECD and hexagonal cell ratio were significantly lower, while the average
cell size, CV%, and central corneal thickness were determined to be significantly higher
in diabetic patients than in healthy controls (p = 0.001). With the presence and
advancement of diabetic retinopathy, the ECD and hexagonal cell ratio decreased, while
the average cell size, CV%, and central corneal thickness increased. When correlation
analysis was performed between corneal morphological features and laboratory data of
diabetic patients, ECD showed a significant negative correlation with diabetes duration
(p = 0.028). Urinary albumin-creatinine ratio (p = 0.041), average cell size and CV
showed a positive correlation with these parameters.
Conclusion: In conclusion, keratopathy is an important complication of type 2 diabetes.
With an increase in the stage of diabetic retinopathy, alterations in corneal findings also
increased. In that respect, we can suggest that keratopathy should be evaluated more
cautiously in diabetic patients.

Background:Patients with type 2 diabetes (T2DM) have an increased prevalence of dyslipidemia, which contributes to their high risk of cardiovascular diseases (CVDs). This study is an attempt to determine the correlation between hemoglobin A1c (HbA1c) and serum lipid profile and to evaluate the importance of HbA1c as an indicator of dyslipidemia with T2DM.
Materials and Methods: This is a prospective and observational study was accomplished at Tertiary care teaching Hospital over a period of 6 months. Patients of either gender with an established diagnosis of T2DM were selected according to the American Diabetes Association criteria (ADA). These criteria set the following as values that are indicative of T2DM: HbA1C ≥6.5%, FPG ≥126 mg/dl, 2-h plasma glucose ≥200 mg/dl during an oral glucose tolerance test (OGTT), or random plasma glucose ≥200 mg/dl.
Results: Blood glucose level was 149.35 ± 13.23 mg/dl and mean HbA1c was 7.96±1.46. Mean total cholesterol was 179.53±16.36, mean total triglyceride was 183.74±17.64, mean LDL was 105.85±8.50, Mean HDL was 36.94±4.28. HbA1c positively and significantly correlated with total cholesterol (r=0.091), LDL (r=0.013), HbA1c negatively and significantly correlated with HDL (r= - 0.126), and did not show any show correlation with VLDL (r=0.024) and total triglycerides (r=0.103).
Conclusion: Our study accomplished that HbA1c has a direct, significant correlation with total cholesterol, triglyceride, VLDL, and LDL among the lipid profile. Significant positive correlation of HbA1c with lipid profiles from our study results implies that HbA1c can also be used as a predictor of dyslipidemia in addition to as a glycemic control parameter for prevention of complication.

Background: The role of serum uric acid as a risk factor for ischemic stroke in patients with type 2 Diabetes Mellitus is controversial and there is little information about it.
Aim of the study: This study was done to estimate serum uric acid levels in diabetic patients with ischemic stroke and to assess its risk factor potential.
Methods: It is a case control study carried out in the medical ward at Al Hussein Teaching Hospital at Al Nassiriyah city at southern of Iraq from June 2018 till December 2018, carried on 119 patient mean ages is 61.89 years. 56 of them was diabetic patients with ischemic stroke were enrolled as a case group and compared with 63 non diabetic patients presented with ischemic stroke also as a control group, Serum uric acid levels were measured in cases and controls (within 24 hours of stroke). The results were statistically analyzed and studied with other risk factors.
Results: Mean serum uric acid level in cases was 6.02 mg/dl where as it was 5.34mg/dl in controls. Hyperurecemia found in 25% of cases , with significant statistical association with increase in TG Cholesterol level p value is0.028 , and hyperurecemia was significant only in old age diabetic (p value less than 0.05) .
Conclusions: There was no significant statistical association between Serum uric acid level and stroke in type 2 DM, but it found to increase other risk factor for stroke especially in old age group , so it can be considered as a risk factor for ischemic stroke in type 2 DM.

Aim: To assess the effect of Platelet Rich Plasma (PRP) in non-healing ulcers.
Material and methods: It was a hospital based prospective cross-sectional &
observational study between July 2020 to June 2021, at Hind institute of medical
sciences, Safedabad, Barabanki. The history and examination were done bedside. In
cases where the condition of patients doesn’t warrant giving history, their relatives or
attendants were interviewed. A predesigned pretested semi-structured questionnaire
was filled by the interviewer. Data was entered in Microsoft Excel sheet. The study area
was General Surgery, Orthopaedics& medicine department, of Hind Institute of
Medical Sciences, Safedabad, Barabanki.Pus culture and sensitivity were sent then after
cleaning the wound with normal saline and betadine solution, already centrifuged
platelet rich plasma was injected subcutaneously inside, in the periphery of wound and
spread over floor of ulcer then dress with non-absorbent dressing. 1st dressing was
changed on the 3rd day of injection then dressing was changed on every 7th day.We
evaluated the effect of 1 dose of platelet rich plasma injection efficacy in wound/ulcer
healing & reduction in wound/ulcer size and follow-up by visual inspection.
Results: At admission, the mean wound area was 388.6±25.35 mm2 which was reduced
to15.54%at3rddayandthisreductionwasfoundtobestatisticallysignificant(p<0.001).
Furtherreductionwasobservedat 14th day (49.66%) and 21st day (64.40%) and these
reductions were statisticallysignificant (p value <0.001).At 21st day the % change in
volume was maximum for venous ulcer (69.25±4.43 %) and minimum for post
traumatic (65.27±9.11 %). No significant difference was found in % change in volume at
21st day among various ulcer types (p value =0.336).
Conclusion: Based on this study observation and result, we proposed that platelet rich
plasma is a safe bio-compatible, cost-effective, less time-consuming procedure and does
not require sophisticated equipment.

schedule and accurate diagnosis. The research centre danger marker for necrotizing
fasciitis score can be useful for distinguishing between instances of cellulitis, which
ought to react to clinical administration alone, and NSTI, which requires usable
debridement notwithstanding antimicrobial treatment.
Objective: To concentrate on the relationship between clinical, lab boundaries and
imaging in the diagnosis of NSTI. To break down the importance of Wong's LRINEC
rules in assessing NSTI, to distinguish the comorbidities related to NSTI and to decide
the meaning of progress in research centre boundaries after the inception of treatment.
Methods: It is a retrospective report where patients with a clinical diagnosis of
complicated delicate tissue disease were enlisted and exposed to investigations at the
hour of confirmation and assessed according to proforma. Subjects were isolated into
NSTI and SSTI groups because of clinical elements, research facility and imaging
discoveries. An Intergroup examination was done to distinguish factors related to NSTI.
Results: Clinical highlights like tachycardia, tachypnea, hypotension, unbalanced
agony, rankles, skin putrefaction, ulceration and change in shading were all together
(p150mg/L, RBS>180mg/dl, Total count>16500cells/mm3, Calcium1.4mg/dl were
fundamentally connected with NSTI (p<0.05). LRINEC rules had responsiveness of
89.1% and a particularity of 94.3 %. Both X-ray and Ultrasonography are pretty much
similarly explicit, however, ultrasonography was more delicate in diagnosing NSTI.
Genuinely critical contrast was noted between boundaries done at confirmation and the
second post usable period following resurgery.
Conclusion: Previously mentioned clinical highlights and lab boundaries can be utilized
to analyze, visualize and screen patients with NSTI. LRINEC is a decent apparatus for
separating NSTI from SSTI. Ultrasonography is more explicit in diagnosing NSTI than
X rays.

Introduction: Diabetes mellitus as we all know is a systemic disorder which affects many organs by causing pathological changes in them. It is considered as a leading cause of increasing morbidity and deaths in today’s world. Many studies suggested that lung is a target organ in DM and that glycaemic exposure is a strong determinant of reduced pulmonary function in DM patients theoretically morbidity, several pathological changes may affect the lungs in patients with DM.
Materials and methods: This prospective study was conducted over a period of one year from January 2021 to December 2021 (1 year). 100 type-2 diabetic patients who were not on insulin visiting Shaheed Nirmal Mahato Medical College (SNMMCH), Dhanbad as in-patients & out-patients were included. The sample size was taken based on the convenience of the study. 100 healthy controls who’s fasting blood sugar (FBS) and postprandial blood sugar (PPBS) were in normal limits from administrative office of Shaheed Nirmal Mahato Medical College (SNMMCH), Dhanbad, and other volunteers constituted the control group. The informed consent of the patient / guardian was obtained.
Results: FBS among cases and controls were compared which shows a mean FBS value of 207.8 mg / dl in diabetic group as compared to a mean value of 97.42 mg/dl in controls with P value of 0.001 which is highly significant. Post prandial blood sugars showed highly significant difference among both groups with mean of 254.41 among diabetic group and 126.65 among controls.
Conclusion: Type 2 diabetes mellitus is associated with restrictive pattern of respiratory abnormality. As the duration of diabetes increases the restrictive profile was more prominent. There was inverse relation between glycaemic status and spirometric indices FEV1 and FVC. Thus, an intensive glycaemic management may reduce the risk of death through an improved ventilator function which is independent of the other beneficial effects.

Aim: Evaluation of adverse drug reactions in patients of diabetes mellitus on 1^st line Anti-tubercular treatment.
Methods: Patients presenting to the Medicine OPD (Diabetic clinic), and Respiratory medicine OPD, KGMU, on specified days of the week diagnosed to be diabetes mellitus with tuberculosis was screened based on selection criteria. Written informed consent was taken from patients. Demographic details of the participants were recorded in semi-structured proforma. The overall description of the adverse drug effect was done for the selected patients. Seriousness of adverse drug effects were evaluated. Assessment of the severity of adverse drug effects were done. Causality assessment of ADRs was assessed by the WHO-UMC causality assessment system and Naranjo’s causality assessment scale. The severity of ADRs was assessed by Hartwig’s Severity Assessment and scale.
Results: In our study, incidence of Adverse Drug Reactions (ADRs) in diabetes mellitus patients receiving 1st line antitubercular treatment was 61.82% (68). Out of 110 patients, 68 patients developed a total 83 ADRs. Most common system involved was gastrointestinal system (24, 28.92%) followed by hepatobiliary system (21, 25.30%) and dermatological system (17, 20.48%). Least common system involvement was oto-vestibular, musculoskeletal and urinary system. Most common ADRs were Hepatitis/Jaundice (25.30%), Pruritis/rashes (20.48%) and Nausea/Vomiting (14.46%). Epigastric pain, Diarrhoea, Anemia/thrombocytopenia, Peripheral neuropathy and Headache was reported in 7.23%, 6.02%, 7.23%, 3.60% and 3.60% of the subjects respectively. According to WHO causality assessment scale, majority of ADRs were classified as probable (48, 57.83%). Possible ADRs were found in 33.74% of the subjects. Certain ADRs were found in 2.41% of the subjects. According to Naranjo’s causality assessment scale, majority of ADRs were classified as Probable (54, 65.06%). Possible ADRs were found in 30.12% of the subjects. Definite and Doubtful ADRs were reported in 2.41% of the subjects
According to Hartwig’s severity assessment level, mild, moderate and severe ADRs were reported in 80.72%, 15.67% and 3.61% of the subjects respectively. According to kappa analysis, the strength of association between Naranjo’s causality assessment scale and WHO Causality Assessment scale to assess ADR is good (kappa value: 0.72, p value: 0.008).
Conclusion: Most of the ADRs belonged to mild category according to the Modified Hartwig and Siegel scale for severity assessment. ADRs induced by ATT are common, which can result in discontinuation of treatment and development of resistant bacilli.

Aim- To study the prevalence of dry eye disease(DED) and its association with diabetic retinopathy (DR), diabetic neuropathy (DN) and other metabolic parameters in patients with type 2 diabetes mellitus. Materials and methods- Dry eye disease was assessed in 102 patients with type 2 diabetes mellitus using OSDI (Ocular Surface Disease Index) score, tear break up time(TBUT) test and Schirmer’s test. All the subjects underwent indirect ophthalmoscopy, DN screening was done based on Revised NDS score, DR was graded according to Early Treatment Diabetic Retinopathy (ETDRS) criteria. The relation of DED with status of diabetic retinopathy, peripheral neuropathy, dyslipidemia, metabolic control and duration of disease was also assessed. Results- The prevalence of dry eye disease was 37.2%.We observed a significant associationof dry eye disease with diabetic retinopathy (p=0.017) and diabetic neuropathy(p=0.019). Conclusion- As the prevalence of DED among diabetics is high and diabetic retinopathy and neuropathy are often found to be associated with DED, therefore, along with screening for DR and DN, assessment of dry eyes should be routinely included in patients with diabetes in ophthalmology clinics.

Background and aim: India is one of the 7 countries of the IDF (International Diabetes Federation) SEA (south-east Asia) region. 463 million people have diabetes in the world and 88 million people in the SEA Region; by 2045 this will rise to 153 million. There were over 77,005,600 cases of diabetes in India in 2020.In our study we tried to determine the risk factors for development of Glaucoma, especially in Type-2 diabetics and its magnitude.
Methods: a cross sectional study done in KIMS OPD, Bangalore between January 2018-may 2019. Diabetes was diagnosed by history and measurement of blood sugar levels. Glaucoma was diagnosed by assessing optic disc morphology, visual fields, and intraocular pressure. Systemic blood pressure was also measured for the patients. Statistical significance was indicated by P < 0.05.
Results: Study cohort included 350 patients with Type-2 Diabetes (150 males and 250 females), mean age of 52+/- 9 years. Prevalence of glaucoma was 16% (95% CI; 13.4-18.3). Out of this 16%, 50% had primary open angle glaucoma, 32% primary angle closure, 12.5% neovascular glaucoma, 5.3% other types. 77% diabetics didn’t have Diabetic retinopathy. Presence of glaucoma was significantly associated with the duration of Diabetes (chi-square=5.80 and p<0.015). Presence of Diabetic retinopathy was Not significantly associated to the presence of glaucoma (odds ratio=1.42). Even presence of systemic hypertension did not affect the magnitude of glaucoma in diabetics.
Conclusion: Screening for glaucoma while screening Diabetic cases may yield us more cases of glaucoma and the duration of diabetes is one of the most important determinants for development of glaucoma.

Background: Diabetes mellitus is a clinical syndrome characterized by hyperglycemia
due to absolute or relative deficiency of insulin. Type 2 diabetes (T2D) occurs due to a
progressive decline in the ability of the pancreas to secrete enough insulin as well as
insulin resistance in insulin target tissues. The pathophysiology of T2D is characterized
by excessive accumulation of ectopic fat in the liver, pancreas, and skeletal muscles,
eventually manifesting as insulin resistance in these tissues and pancreatic beta cell
dysfunction that ultimately leads to hyperglycemia.Metabolic abnormalities such as
dyslipidemia, hyperinsulinemia, or insulin resistanceand obesity play key roles in the
induction and progression of type 2 diabetesmellitus (T2DM). Objectives: To estimate
the levels of serum myeloperoxidase, apolipoprotein B and glycated hemoglobin in type
2 diabetic patients and also in healthy controls, to observe the relationship between
serum MPO with apo B and glycated hemoglobin and also between glycated
haemoglobin with apo B in type 2 diabetic patients and healthy controls.
Materials and Methods: Case control study was done taking 30 cases of type 2 diabetes
mellitus and 30 age and sex matched healthy controls. In all the subjects, concentrations
of HbA1c, serum apo B and serum MPO were estimated. HbA1c was measured by
turbidimetric method and serum Apo B by immune turbidimetric method using semi
auto analyser CHEM 5 Plus. Serum MPO was measured by ELISA method using
ELISA reader.

Background: Coronavirus disease 2019 (COVID-19) is a new respiratory infection caused by a coronavirus known as SARS coronavirus 2. (SARS- CoV-2). The virus is a member of the coronavirus family, which are zoonotic pathogens that cause and transmit infections between humans and various animals. The World Health Organization (WHO) has designated coronavirus disease 2019 (COVID-19) a pandemic, with 20% of infected individuals requiring hospitalisation and 6% requiring critical care and invasive ventilatory support. Co-morbidities are thought to be a greater risk for reducing the survival probability of SARS-CoV-2 patients. Different types of pre- existing diseases have been identified as co-morbidities in SARS-CoV-2 infection, which increases susceptibility and poses risks of more severe outcomes and deaths in COVID-19 patients. This study is to identify different co-morbidities of the patients who died due to COVID-19 admitted in GMERS medical college and general hospital in city Gandhinagar in Gujarat state.

The metabolic syndrome is defined as a clustering of key cardiovascular risk factors,
namely, abdominal obesity, dyslipidemia, hyperglycemia and hypertension in a single
individual. Gerald Reaven introduced the concept of the syndrome in 1988.This crosssectional
study was conducted in 120 in which 60 non diabetic and 60 type 2 diabetic
patients, 2013 to 2015 in the department of biochemistry, Mediciti Institute of Medical
Sciences, Hyderbad. Ethical clearance was obtained for the study. Informed consent
was obtained. 60 subjects with type 2DM were included in the study. Subjects in the age
group of 30-65 yrs in both genders, meeting the Type 2DM, FBS and PLBS meeting the
criteria were taken up in the study. Maximum prevalence of Metabolic syndrome was
observed in diabetic male harmonised criteria (73.3%) and diabetic female WHO
criteria (76.6 ). A fair agreement was observed between WHO and HAR criteria by
Kappa statistics. A two tailed significant correlation were found in diabetic male
patients (using WHO,HAR criteria ) than female patients (using CDS) criteria

Aim: To evaluate fatty liver disease and cardiovascular diseases in type 2 diabetic patients
using ultrasonography.
Methodology: The prospective and observational study was conducted in the Department of
Radiology, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Himachal
Pradesh for the period 9 months. 300 patients diagnosed with type 2 diabetes and ultrasound
abdomen showing fatty changes in liver without any other co-morbidities were included.
Patients were divided in three groups according to the duration of the diagnosis of diabetes.
The distributions of different groups were GROUP A- less than 5 years, GROUP B-in
between 5 to 10 years and GROUP C-more than 10 years. A brief history was taken of the
patient’s complaints and then the patients Random blood sugar and BMI values, as mentioned
in the patient’s case paper were recorded and then ultrasonographic evaluation of the study
subjects was performed by a single radiologist and the following parameters were examined
after obtaining informed consent-Liver echogenicity, Portal Vein Doppler study, Mesenteric
fat pad thickness and Carotid Artery Doppler study. Study method was Interview schedule
questionnaire, OPD records, bedside tickets, physical examination and laboratory
measurements.
Results: Out of the 300 patients, 145 (48.3%) were males, and 155 (51.7%) were females.
Majority (39%) of the patients belonged to 50-60 years of age group followed by 25.7%
patients in the age group of 40-50 years. 18.3% belonged to 60-70 tears of age, 10.7% were
less than 40 years, and 6.3% belonged to more than 70 years of age. Out of the 300 cases, 225
(75%) cases had fatty liver and 75 (25%) cases had non-fatty liver. Out of the included
patients, 33.4% (100) were in group A, 40% (120) were in group B, and 26.6% (80) were in
group C. Out of 300 patients, 70 (23.3%) cases had ischemic changes, but majority of patients
(230, 76.7%) did not have ischemic changes.
Conclusion: Liver ultrasound examination should be considered in every patient with newly
diagnosed type 2 diabetes because the prevalence of NAFLD is extremely high in this group
of patients. It can be said that there was an association between cardiovascular risk factors
and NAFLD in patients with type 2 diabetes mellitus.

Diabetes mellitus is a non-communicable chronic metabolic disorder. The association
between sensorineural hearing loss and diabetes has become an important subject of research.
Pathophysiology of hearing loss in diabetes is not still well explained. Usually gradual,
bilateral, sensorineural hearing loss at high frequency is seen in diabetes mellitus. Our study
aims to know the prevalence of SNHL in DM and its relation to HbA1c. A total of 300
subjects including 150 healthy individuals age and sex matched as control and 150 patients of
type 2 diabetes between 10-50 years age group including 78 males and 72 females were
included in the study. Fasting blood sugar and HbA1c of all the subjects were taken for the
study and after that pure tone audiometry was performed (PTA). By observing the data
degree, type and correlation with HbA1c of hearing loss was concluded. 28% diabetic
patients suffered with SNHL while 72% were found with normal hearing threshold. Among
42 patients 23 mild, 9 moderate, 9 moderately severe and 1 severe degree hearing loss cases
were found in diabetic group. Hearing loss was found on higher frequencies. Association
between hearing loss and HbA1c was observed and it was highest in the 10-13.9% range but
this correlation was not found significant (p value >0.05) in our study.

Background: Blood glucose and electrolytes have a complicated relationship that is
influenced by a number of other factors such as age and concomitant conditions. As
there is paucity of such studies in India, so present study was to determine the most
prevalent electrolyte disturbances among diabetic in-patients and to explore an
association between blood sugar and electrolyte imbalances.
Materials and Methods: The present cross-sectional study was carried for a duration of
two years among 271 adult patients with diabetes mellitus admitted to the wards and
ICU in a tertiary care centre. Patient-specific information was collected in a structured
schedule and blood sample was collected for laboratory investigations after obtaining
written informed consent. All tests were performed at a 5% level of significance; thus,
an association was significant if the p value was less than 0.05.
Results: In present study (Table 1), the mean age of study subjects was 58.92 ± 13.15
years, with nearly equal representation from males (49.4%) and females (50.6%). The
mean duration of diabetes among subjects was 9.72 ± 6.57 years. The mean HbA1C was
7.65 ± 1.23 % which reflect uncontrolled diabetes. The most common electrolyte
imbalance among enrolled subjects was hyponatremia (33.6%). The mean levels of
serum sodium (group A: 132.82 ± 3.99 vs group B: 135.62 ± 5.12), were statistically
different (p<0.05).
Conclusion: The importance of evaluating serum electrolytes in patients with type 2
diabetes was presented in the study. Electrolytes, particularly sodium, chloride, and
potassium, become significantly disturbed as fasting blood glucose rises.

Aim: To assess the gallbladder volume in T2DM patients and in healthy controls by using
Ultrasonography.
Methodology: This cases control study was conducted among 50 diabetic patients enrolled
from the diabetes clinic of the Medicine Department of Maharishi Markandeshwar medical
college and hospital Kumarhatti, Solan, Himachal Pradesh and 50 healthy patients (control
group). 30-60 year patients of type 2 diabetes mellitus diagnosed since 5 year or more and
functioning gall bladder with well controlled blood sugar levels. The diagnosis of diabetes in
these patients was in accordance with WHO criteria i.e., fasting plasma glucose level ≥126
mg/dl, and ≥200 mg/dl plasma glucose level after 2hr of ingestion of standardised 75gm
glucose. An informed consent was taken from all the subjects in the study and control groups.
All the patients were randomly selected for the study among patients regularly attending
diabetic clinic of this hospital and following our criteria’s of selection.
Results: Mean age of diabetic Patient was 48.5 years in study group and 53 years in
control group. 46% of diabetics were males and remaining 54% were females, whereas in
control group male to female ratio was equal, means 50% males and 50% females. 90% cases
in control group had no gall bladder disease, while only 66% cases in group with diabetes
had no gall bladder disease. In group with DM type 2, 10% had cholelithiasis, 8% had
cholecystitis and 3% had sludge: while in control group, 4% had cholelithiasis, 2% had
cholecystitis and 4% had sludge. The percentage of contraction of gall bladder had reduced
markedly in chronic diabetics (45.6 + 9.57) as compared to controls (65.2 + 7.34) (p value-
0.001). The fasting gall bladder volume in chronic diabetics was higher (43.47 + 5.35) than
that of controls (28.45 + 4.26) and the difference of values was found to be highly
significant (p value 0.001).
Conclusion: In patients of diabetes mellitus type 2, higher fasting gall bladder volume and
decreased percentage of contraction are observed. Therefore, all T2DM patients should
be evaluated using ultrasonography for the presence of increased fasting gallbladder
volumes to assess the risk of progression to gall stone disease.

The prevalence of cardiac autonomic neuropathy (CAN) in type 2 DM patients increases with
the duration and poor glycemic control. Patients with CAN are at increased risk for
autonomic dysfunction like resting tachycardia,abnormal systolic and diastolic function
leading to syncope and dizziness, prolonged QT interval, silent ischemia/infarction, lethal
arrhythmias and sudden death.Usage of 5 simple and cheap bed side tests for autonomic
function and corrected QT interval from ECG are helpful in early diagnosis of CAN. Early
recognition of CAN is helpful in delaying effects of CAN by strict control of blood sugar and
following healthy life style. Our study was conducted on100known and newly diagnosedType
2 Diabetes Mellitus patients<60 years whopresentedto Medicine OPD and admitted in IPD
wardsin Maharani LaxmiBai Medical College.Out of total 100 patients,49% had normal
score(0,1); 25% had borderline score(2,3,4); rest 26% had abnormal score ≥5; the prevalence
of CAN was 51%.Among 100 patients 47% patients were foundwith poor glycemic control
(HbA1C ≥ 8),in these 17% had early and 21% had definite CAN. Out of 100 patients of the
study, 55% patients had QTc>440ms out of which 17% had early and 23% had definite CAN.
The CAN also increased with older age group. So it is important to diagnose CAN early in
asymptomatic diabetics. There is significant correlation between CAN and QT prolongation.
QT interval in ECG can be used to diagnose CAN with reasonable sensitivity and specificity.
Usage of 5 bedside autonomic function tests are very helpful in early diagnosis of CAN.Strict
control of blood sugar can delay the early development of CAN. Intensive control of blood
sugar can delay the early development of CAN.

Introduction: Diabetic foot and diabetic ulcers are common complications of diabetes mellitus.
It affects daily life of patients and lead to amputations. The study was conducted to see the
effect and role of superoxidised solution and gel (microdacyn) in promoting the healing and
treatment of diabetic foot ulcer.
Material &Methods: The wound site was cleaned with normal saline followed by application
of superoxidised solution for 30 seconds and then followed by application of wound care
hydrogel. Observations were made during dressing and examination of the patients/ wounds
was done on the day 7,14,21,28 and at follow-up of 15 days. Rate of contraction of wound is
measured in cm2.
Results: Mean age of patients in the study was 50.0687±11.85 years with equal male to female
ratio. Superoxidised solution provides good wound healing and mean hospital stay was
10.49±4.24 days. Significant reduction of wound is seen in cases with short duration of ulcer
and short duration of diabetes (p<.05).
Conclusion: Superoxidised solution was associated with faster healing of ulcers without any
major complications, proving SOS to be safe and efficient as a wound care product in the
management of lower limb ulcers.

Diabetes is a major, non-communicable disease with increasing prevalence globally and
will be the seventh leading cause of death worldwide by 2030 as estimated by the WHO
report in 2011. Saudi Arabia is considered to be one of the highest countries in the Middle
East for the incidence of diabetes mellitus. Type 2 diabetes affects the most productive
midlife period but has also started to appear in younger age groups. Type 2 diabetes is now
increasingly diagnosed among adolescents and young adults, data are lacking regarding
knowledge about diabetes mellitus among school students in Saudi Arabia but it is a
potentially preventable disease through a combination of lifestyle modification and
pharmaceutical treatment.

Background : This study aims to determine the effect of a combination regimen of
metformin and without metforminon the conversion of sputum smear in new cases
of pulmonary TB patients with type 2 DM.
Materials andMethods: This cross-sectional study was conducted at Wahidin Sudirohusodo
Hospital, Makassar Center for Lung Health, Kasi-Kasi, and Sudiang Community
Health Center from August 2019. This study involved 83 new cases of pulmonary
TB subjects with T2DM. New cases of pulmonary TB patients were obtained by examining AFB sputum in DM patients who had symptoms of pulmonary TB and had no history of suffering or receiving previous anti-TB drug therapy.Pulmonary TB patients receive category 1 anti-TB drugs andDM subjects were divided into 2 groups is metformin and non-metformin. Then, smear sputum is examined in the 2-month intensive phase of anti-TB drug therapy to assess the conversion of AFB sputum.
Results: From a total of 83 new cases of pulmonary TB and T2DM, 44 subjects received a combination regimen of metformin and 39 subjects non-metformin. In this study, there were 42 (95.5%) subjects who conversion sputum smear in the metformin group more higher than in the  non-metformin group but statistically it was not significant (p = 0.282).
Conclusion: There was no significant relationship between the metformin and non-metformin groups on the conversion of AFB sputum smear in new cases of pulmonary TB patients and T2DM.

The aim of this study is to retrospectively analyse the prevalence of diabetes mellitus and hypertension among patients undergoing  dental implant treatment in a dental hospital. All the patients reported in the month of June 2019 to March 2020 for implant placement was chosen for the study. Implant placement data of patients with diabetes mellitus and hypertension was collected from the dental hospital record system. Result data was tabulated in excel and statistical analysis was done using Statistical Software for the Social Sciences (SPSS) software. The non parametric Chi square test was done for statistical analysis. The prevalence of diabetes mellitus in patients undergoing implant placement is 4.2%, hypertension is 2.2% and coexisting diabetes mellitus and hypertension is 1.7% with a higher incidence in the male population and more common in the age group of 40 to 60 years. Knowledge about the prevalence of these conditions will be helpful to the clinician for proper management setup and precise diagnosis before implant therapy can prevent surgical and postoperative complications resulting in long term success of dental implants

In today’s world, Diabetes Mellitus is a disease, that is considered to be an extensive noncommunicable disease which has a great effect our day to day living. In the 21st century, changes in natural life style and labor culture are some of the main reasons for India to have 62 million diabetic cases as of today. Analytical Computational Techniques can be applied on clinical immense data, the enormous quantity of data produced in the healthcare schemes, there is a option to form medicinal intelligence which will initiative medical forecast andpredicting in future. By advancing medical intelligence and with the help of development model, prediction and detection of diabetes disease can be done. With the increase in complexity to the problems, the accuracy percentage also varies. LGBM - Light Gradient Boosting Algorithm is one such algorithm that can be used as it depends on decision tree algorithms and it can be used in predicting the accuracy to attain the desired results. With the
existing PIMA Indian Dataset the accuracy is calculated as 95.20% using LGBM Algorithm . Therefore by using the LGBM classifiers, we can develop a data model for diabetes detection and prediction.

Diabetes mellitus is a group of physiological dysfunctions characterised by increased blood
glucose level resulting directly from insulin resistance or impaired insulin secretion leading to
micro and macrovascular complications. The oral complications of diabetes mellitus includes
increased incidence of dental caries, dry mouth, burning mouth syndrome and periodontitis.
Assessment of blood glucose levels is essential prior to any specialised procedure to avert any
further oral and systemic complications. Screening of diabetes mellitus condition has become
a necessity in developing countries and study of this nature will have enormous public health
impact. The aim of this study is to assess the prevalence of diabetes mellitus in patients visiting
different outpatient departments of private dental college hospital, Chennai. All the cases
referred from the month of June 2019 to March 2020 for random blood sugar tests were
chosen for the study. Data was collected from the dental hospital record system. Result data
was tabulated in excel and imported to SPSS for correlation and association. P<0.05 was
considered to be the level of statistical significance in this study. Within the limits of the
present study, diabetes mellitus prevalence in random blood sugar tested patients is 33.3 %
with a higher male incidence and more prevalent among the age group of 41 to 60 years.
Knowledge about the prevalence of diabetes mellitus in the patients visiting dental hospital will
be helpful to the clinician to prevent any further complications before any specialised
procedure.

Background:Coronary artery disease is higher in risk with diabetes mellitus, and diabetesrelated
deaths can lead to ischemic heart disease. We examined the relationship between the
glycemic regulation as determined by Hemoglobin A1c and the occurrence of periprocedural
complications in patients who performed percutaneous coronary intervention (PCI) and had
Coronary artery Bypass Graft (CABG)
Objective: To identify associated complications and their sites with Percutaneous Coronary
Intervention in diabetic patientswho performed Coronary Artery Bypass Graft.
Methods:The cross-sectional analysis was performed at the cardiology department in Zagazig
University Hospital in which all 24 CABG & DM patients were included during the period
between January 2019 and January 2020 divided into 12 patients with controlled
DM(HbA1c>7)&12 patients with uncontrolled DM (HbA1c<7).Both patients had a complete
medical history, a detailed clinical evaluation, and preoperative laboratory work: role of the
renal, completion of blood counts as a marker for regulation of DM, ECG, and ECHO.
Glycosylated Hemoglobin HbA1c was used.

Background:There is an increase of risk of coronary artery disease about 4-fold with diabetes
mellitus, and ischemic heart disease is liable for diabetes-related deaths. In this study, we
examined the association between glycemic control, as determined by Hemoglobin A1c, and the
incidence of periprocedural complications in diabetic patients who had coronary artery bypass
graft (CABG) undergoing percutaneous coronary intervention (PCI).
Aim of the study:To assess the effect of control of DM on the outcome of PCI in patients who
underwent CABG.

Introduction: Catheter-related bloodstream infection (CRBSI) is a critical problem in dialysis center.
Aim: To study the prevalence of central venous catheter related blood stream infections and to identify the microbiological profile of organisms causing CRBSI.
Materials and Methods: This prospective observational study carried out at Dialysis unit over a period of two years on 145 hemodialysis patients, who had cultures of catheter and blood samples were studied.

Background: Calprotectin was identified as an endogenous Toll-liken receptor 4 (TLR4) activator and as a receptor for progressive glycation end products (RAGE), Elevated Calprotectin plasma levels have been recorded in various chronic inflammatory conditions, expecting microvascular alterations in patients with type 2 diabetes (T2DM). Objective: To make an up to date review of Serum level of Calprotectin as a predictor for early diagnosis of peripheral neuropathy in type 2 diabetes patients. Patients and methods: A total number of 90 subjects were included in the study after fulfillment of the inclusion and exclusion criteria. Calprotectin was measured for all the 90 subjects. Results: Serum calprotectin levels were significantly higher in group III “diabetics with neuropathy” compared to group II “diabetics without neuropathy “and group I “healthy controls” Conclusion: In Type 2 diabetes patients with peripheral neuropathy, elevated levels of calprotectin have been identified.

Introduction: Catheter-related bloodstream infection (CRBSI) is a critical problem in dialysis
center.
Aim: To study the prevalence of central venous catheter related blood stream infections and to
identify the microbiological profile of organisms causing CRBSI.
Materials and Methods: This prospective observational study carried out at Dialysis unit over
a period of two years on 145 hemodialysis patients, who had cultures of catheter and blood
samples were studied.
Results: A total of 557 haemodialysis catheters (tunnelled and non-tunnelled) were
inserted during the study period, and among them, CRBSIs was seen in 145 cases.Mean
duration of dialysis catheters in situ was 20.6days.99 (68.2%) patients were males, and 46
(31.7%) were females. Diabetes mellitus (76.5 %) was the most common premorbid illness
associated with CRBSI. 81.3% patients found to be below 10 mg/dl of Hb, and
68.3%patients had leucocytosis. Among 145 of CRBSI, blood cultures were positive in 48
patients, and 97 patients were culture negative.45.8% isolates were gram-positive and
52.8% isolates were gram-negative bacteria, and one isolate was found to be fungal
infection.Among gram positive, CONS were most isolated, followed by Enterococcus,
MSSA and MRSA.

To study the clinical profile, etiology and various patterns of Macular Oedema. Materials & Methods: A cross sectional case study was done from December 2018 to May 2020 at Krishna institute of medical sciences, Karad. Detailed history and examination of the patients done including Amsler Grid, Color Vision using Ishihara’s Chart and Slit lamp 90D examination and dilated fundoscopy. Pattern of macular oedema was evaluated and subsequently documented using Fundus camera, OCT and FFA.

Diabetes mellitus is the most common endocrine disease, therefore it is a priority medical and social problem. Often with diabetes, it is the ocular manifestations that primarily lead to the disability of patients. The review contains an analysis of the morphological experimental and clinical studies of fundus elements in patients with DM - original research, reviews and monographs by domestic and foreign authors, mainly in recent years. Clinical and morphological changes in diabetes are discussed, early diabetic changes in the retina, blood vessels, and macula are described. The important role of changes in the internal plexiform layer and ganglion cells

Proton pump inhibitors (PPIs) are the commonly recommended treatment for gastric abnormalities. The structural scaffold of PPIs (Pantoprazole; PPZ) provides an incalculable chance of association with diverse biological receptors which indicate a huge possibility of pleiotropic therapeutic impact which needs to be explored. Recently, several studies report the cardioprotective events of PPIs, but the underlying mechanism is not clear. Four groups having six animals in each were considered for this study. STZ (50 mg/kg/i.p) was given to induced chronic diabetes mellitus (DM) and vascular endothelial dysfunction (VED). PPZ (4 mg/kg/p.o/daily for 8 weeks) was evaluated against DM induced VED by measuring endothelial relaxation, aortic/serum nitrite/nitrate concentration, asymmetric dimethylarginine (ADMA), aortic superoxide anion generation, serum thiobarbituric acid reactive substances (TBARS) and dimethylarginine dimethylaminohydrolase (DDAH) in the cell lysate of each animals group. PPZ significantly overcome the perturbed level of hyperglycemia measured by blood glucose level, increase the availability of NO measured by aortic/serum nitrite/nitrate concentration. Treatment with PPZ showed the determinate lessening of tissue injuries as it averted increase expression of VED measured by ACh-induced endothelium-dependent relaxation, and diminution in oxidative stress, plasma ADMA level, and DDAH concentration in the cell lysate. The vascular protective potential of PPZ has a strong correlation with the DDAH/ADMA/eNOS/NO signaling pathway. Furthermore, the study also explored the antioxidant activity of PPZ which may also facilitate this protective pathway by increasing the bioavailability of NO in the endothelium.

Diabetes mellitus is a metabolic disease characterized by an increase in blood sugar levels that cause vascular complications and circulatory disorders. Hot and cold water soaking in the feet can increase blood flow and blood vessel pumping. Objective: to assess the effect of hot and cold water soaking in the foot blood circulation in patients with diabetes mellitus. Methods: A quasi-experimental was conducted with pre-test and post-test approach with control. Respondents were 35 people per group by consecutive sampling. Data were analysed using Wilcoxon signed ranks test and the Mann Whitney Test. Result: there was a significant effect between the average value of Ankle Brachial Index before 0.823 (SD 0.025) and after treatment 0.95 (SD 0.95), p-value = 0.00. The mean difference was obtained p = 0.00, if the p value <0.05, there was a significant difference in the difference in the mean value. Conclusion: it was found that the leg blood circulation was getting better after the hot cold water soaking. It is recommended for nurses to make hot and cold water immersion into one of the independent nursing interventions in providing nursing care to diabetes mellitus patients.

In pathological conditions such as Diabetes Mellitus (DM), increased oxidative stress can cause a decrease in endogenous activity in the body so the body is unable to detoxify free radicals that cause cell damage. Some of natural antioxidant sources are moringa leaves (Moringa oleifera Lamk.) and clove flowers (Syzygium aromaticum Merry & Perril). The purpose of this study was to determine the enzyme activity of Superoxide Dismutase (SOD) and Glutathione Peroxidase (GPx) in a mixture composing of ethanol extract of moringa leaf and clove flower towards animals with DM conditions. This research is an experimental laboratory study using a post test only group design. The subjects of this study were 40 white male Wistar rats (Rattus norvegicus) strain which were DM conditioned by streptozotocin induction. Rats were randomly grouped into 8 groups, and each group consisted of 5 rats. The combined dosage of the ethanol extract of moringa leaves and clove flowers used is a combination I : 150: 40 mg / kg body weight rat, combination II 100: 80 mg / kg body weight rat and III 50: 120 mg / kg body weight rat. The results showed that the combination of ethanol extract of moringa leaves (Moringa oleifera L. and clove flower (Syzygium aromaticum Merry & Perril) increased the antioxidant enzyme activity of SOD and GPx in animals with DM conditions.

At present, the important role of comorbid diseases, including diabetes
mellitus, in the course of COPD has been determined. Concomitant diabetes
mellitus accelerates the progression of ventilation disorders and worsens the
prognosis, increasing the risk of mortality from COPD. Diabetes mellitus is
associated with COPD from 2 to 16%. Potential mechanisms underlying the
high incidence of the combined course of COPD and type 2 diabetes mellitus
include: chronic systemic inflammation, oxidative stress, and chronic
hyperglycemia.
Purpose. determination of clinical, functional and radiological features
of COPD in diabetes mellitus.
Materials and methods. We examined 75 patients and studied the
features of the course of COPD in combination with diabetes mellitus in
comparison with the results of examining patients with COPD and patients
with diabetes mellitus by X-ray and MSCT.
Results. Patients with COPD in combination with diabetes mellitus are
characterized by more pronounced respiratory failure and chronic cor
pulmonale, frequent exacerbations and more pronounced hypoxemia in
comparison with patients with COPD. Standard radiography did not reveal
pronounced differences between the examined groups of patients with COPD.
COPD is formed as a result of damage to the small bronchi, which determines
the characteristic clinical and radiological symptom complex. In the structure
of COPD, there is a pulmonary component and systemic manifestations that
aggravate the disease. The manifestations of diabetes mellitus are based on
micro- and macroangiopathies that affect pulmonary microcirculation.
Conclusions. Diagnostically significant for COPD during MSCT is a
symptom of expiratory "air trap", combined with expansion and deformation of
the bronchi, up to bronchioectasis. At MSCT in patients with COPD and
diabetes mellitus, pathognomic changes characterizing microangiopathy:
dilated parenchymal vessels, focal-like shadows of vascular origin with a
diameter of 2-5 mm, a clear-cut shape of the vessels, which are considered as a
consequence of specific microangiopathy and fibrotic changes in COPD.

Abstract. The presence of cardiovascular autonomic neuropathy (CAN) significantly
worsens the prognosis and course of the underlying disease. So in patients with diabetes
mellitus (DM) and CAN, the mortality rate for 5 years is five times higher compared to
patients without this complication. Due to the fact that CAN is closely associated with
cardiovascular pathology, many authors consider CAN as a significant factor in
cardiovascular risk. Purpose. To establish clinical, functional and metabolic changes in
diabetic autonomic cardiovascular neuropathy in children with type 1 diabetes. Materials and
methods research. The total number of patients studied by us was 114 children with type 1
diabetes mellitus aged 4 to 18 years. We conducted laboratory and instrumental research
methods. Laboratory methods: general clinical research (general analysis of blood and urine,
studies of blood sugar), biochemical methods (total blood protein, bilirubin, cholesterol,
triglycerides, creatinine, urea, electrolytes, glycated hemoglobin), 24-hour heart rate
monitoring with circadian index estimation was used and parameters of time and frequency
analysis of heart rate variability. Conclusion diabetic autonomic cardiovascular neuropathy in
children with type 1 diabetes is characterized by the development of tachyarrhythmic rhythm
disturbances, as well as the formation of rigidity of the heart rhythm and a decrease in the
sensitivity of the sinus node to parasympathetic influences according to a temporary analysis
of daily monitoring of heart rhythm.

Abstract: Diabetes mellitus is characterized by loss of glucose homeostasis as a result of impaired secretion and function of insulin. The present study was designed to evaluate the role of flower extractof Bergenialigulataagainst diabetesin Streptozotocin induced diabetic rats. Albino Wistar rats weighing 120-150g of either sex were selected for the study.After a week of acclimatization, the rats were subjected to overnight fasting. Diabeteswas induced by intraperitoneal injection of Streptozotocin, freshly dissolved in citrate bufferpH 4.5.In the present study the STZ control animals showed enhanced gluconeogenic enzymes and diminished glycolytic enzymes there by it disturb the glucose homeostasis and diminished insulin production leads increased serum glucose levels. Treatment with flower extract ofBergenialigulata(AFBL) showed significant balancing of glucose homeostasis through reduction in gluconeogenic enzymes and elevation of glycolytic enzymes.The selected flower extract ofBergenialigulata(AFBL) showed in vivo antioxidant activity, antihyperglycemic activity, hepatoprotective activity, nephroprotective activity and finally glucose homeostatic activity might be due to the potent phytoconstituents present in the selected flower extract

Abstract— Durian seed flour is a source of carbohydrates that has the potential to be used to meet the carbohydrate needs of Type 2 Diabetes Mellitus (DMT-2) sufferers, but before it is used to fulfill carbohydrate needs in diabetes sufferers, an in vivo test is needed to identify the glycemic index (GI) of the flour. This study aims to determine the glycemic index of durian seed flour given orally to Sprague Dawley rats. This research was arranged in 2 steps, namely the manufacture of durian seeds flour and the glycemic index test with 5 repetitions with time variations 0; 30; 60; and 120 minutes at 3 days intervals using a glucometer. Rats were grouped into 3 groups each consisting of 2 rats. Flour was suspended in 0.1% sodium carboxymethyl cellulose (Na-CMC) at a dose of 0.5625 g, positive control was 1.125 g of glucose that given in an oral way. Data in the form of test animal blood glucose levels versus time were analyzed into the Area Under Curve (AUC) glucose levels versus AUC. GI calculations were carried out by comparing AUC of durian seed flour to glucose AUC. The results of the research and calculations carried out obtained the GI of durian seed flour of 10.90 with low criteria category. With this GI value, it can be stated that durian seed flour has the potential as a source of carbohydrates for DMT-2 sufferers.

Diabetes Mellitus (DM) is a chronic disease that has become a major health problem in Indonesia. The Chronic Disease Management Program (Prolanis) developed by BPJS Kesehatan in collaboration with First Level Health Facilities (FKTP) seeks to promote and prevent DM disease control. Efforts made include controlling the glycemic index to prevent microvascular and macrovascular complications that may occur with activities including medical consultation, counseling, home visits, club activities, and monitoring of health status.
Aim : The purpose of this study was to analyze the effect of DM patient adherence in participating in Prolanis activities on the patient's HBA1C profile.
Method:This study is an analytical study using a retrospective cohort design. The research data is secondary data obtained from the Medical Records of DM patients from January-April 2019. The research subjects were 42 DM patients who were registered as active Prolanis participants who had HBA1C data at the April 2019 examination.
Result: The results of this study showed that the mean HBA1C value in 22 patients who routinely followed prolanis activities (7.2 ± 1.48)% was more controlled than the mean HBA1C in 20 patients who did not routinely participate in prolanic activities (9.27 ± 2.06)% .
Conclusion: From this study it can be concluded that there is a significant difference between DM patients who adhere to the schedule of prolanis activities and patients who do not comply with the schedule of prolanist activities at the UPTD Puskesmas Nursing Ngletih Kediri City with a value of p = 0.001 (p <0.05; CI = 95% )

Nowadays, the incidence of Diabetes Mellitus (DM) is growing around the world. In fact, it is one of the most serious diseases among adults in the age of 45 and a life - threatening disease over the age of 50, resulting to be the leading causes of death in which Filipinos are also affected by the disease. One of the most known way to treat DM is using insulin. However, side effect, toxicity, and organ damage may happen due to continuous usage of synthetic anti-hyperglycemic agent. Therefore, finding non-toxic and affordable treatment for Diabetes such as medicinal plants is presented. Present investigation was undertaken to investigate the ability of Passiflora edulis sims (yellow passion fruit) pulp juice as anti-hyperglycemic agent on male Sprague-dawley rats, and to compare and evaluate which concentration used in the study of Passiflora edulis sims pulp juice is significantly better as anti-hyperglycemic agent. Thirty (30) individual rats were used in this experiment, 10 of them are used for toxicity testing and no toxic effect has been observed after 24 hours. The remaining 20 rats were randomly divided into five (5) groups, DM was induced by using Alloxan monohydrate dissolved in 0.5 M buffered citrate at a pH of 4.5 and was injected intraperitoneally. Treatment was done by oral administration of yellow passion fruit pulp juice, 1ml, 1.5ml, 2ml, and 2.5ml respectively. The effectiveness of fruit juice was compared with a control group this include diabetic rats treated with water. Results of the study revealed that 1.5 mL, 2mL and 2.5mL concentration of the fruit juice significantly decrease the blood glucose of the diabetic rats while pre and post blood glucose only shows a significant decrease on group 4 and group 5, the highly evidence of anti-hyperglycemic factor occur. Therefore, the Passiflora edulis sims pulp juice fruit juice can be used as alternative treatment for diabetes mellitus

Objective: To describe the features and mechanisms of development of metabolic
syndrome (MS), type 2 diabetes melitus (DM2) and intermediate states of glycemia in
psychosis the occurrence of these disorders, the values of total cholesterol (TC),
fractions of high density lipoproteins (HDL), very low density lipoproteins (VLDL),
triglycerides (TG), values of atherogenic coefficient (AC), insulinemia, С-peptidemia,
insulin resistance (IR) the level of glycated hemoglobin (HbA1c) in a sample of patients
with schizophrenia and in mentally healthy individuals.
Materials and methods: The frequency of carbohydrate metabolism disorders (CMD) was
studied. Fasting glycemia was determined, and in the presence of its violation, a glucose
tolerance test was performed. MS components were studied in patients with DM2,
plasma concentrations of TC, HDL, VLDL, TG, C-peptide (CP), insulin and HbA1c were
determined in patients with DM2, AC values and IR indices were calculated using
HOMA-IR and CARO criteria.
Results: CMD in schizophrenia are more common than among mentally healthy subjects,
amounting to 13.1% (p=0.02), and the main condition here is a significant number of
individuals with impaired fasting glycemia (IFG) and impaired glucose tolerance (IGT)
among women (CMD p=0.01; IGT p<0.001; IFG p=0.03). A feature of psychiatric
sampling is a decrease in HDL by 16.4% (p=0.03) and an increase in AC by 52%
(p=0.02). Mentally ill men with MS are characterized by a significantly large value of AC
(p=0.019), insulinemia (p=0.02), CP level (p=0.02), HOMA-IR (p=0.01) and CARO
(p=0.04) values than in mentally ill patients with DM2 without MS. In comparison with
the control, regardless of gender, the schizophrenic patients with DM2 have significantly
lower values of insulin (p=0.03), C-peptidemia (p=0.04) and IR, according to the criteria of
HOMA-IR (p=0.01) and CARO (p=0.03).

We examined 60 children from 5 to 17 years old in the regional endocrinological dispensary in Bukhara in the children's department with diabetes mellitus. The program "Healthy Tooth" was developed according to the following parameters: anamnesis of life, the state of the periodontium, the state of the mucous membrane of the oral cavity, the intensity of the spread of caries, the state of occlusion, the state of hygiene of the oral cavity, the state of the tongue. In all children, we took into account the following survey indicators: blood sugar level, age, hygiene index, PMA index and indices kp, KPU + Kp, KPU. At the same time, a comprehensive study of the oral cavity was carried out, which included the identification of patients' complaints, anamnesis, and a visual examination.

Diabetes Mellitus (DM) is a chronic disease that has become a major health problem in Indonesia. The Chronic Disease Management Program (Prolanis) developed by BPJS Kesehatan in collaboration with First Level Health Facilities (FKTP) seeks to promote and prevent DM disease control. Efforts made include controlling the glycemic index to prevent microvascular and macrovascular complications that may occur with activities including medical consultation, counseling, home visits, club activities, and monitoring of health status. Aim : The purpose of this study was to analyze the effect of DM patient adherence in participating in Prolanis activities on the patient's HBA1C profile. Method:This study is an analytical study using a retrospective cohort design. The research data is secondary data obtained from the Medical Records of DM patients from January-April 2019. The research subjects were 42 DM patients who were registered as active Prolanis participants who had HBA1C data at the April 2019 examination. Result: The results of this study showed that the mean HBA1C value in 22 patients who routinely followed prolanis activities (7.2 ± 1.48)% was more controlled than the mean HBA1C in 20 patients who did not routinely participate in prolanic activities (9.27 ± 2.06)% . Conclusion: From this study it can be concluded that there is a significant difference between DM patients who adhere to the schedule of prolanis activities and patients who do not comply with the schedule of prolanist activities at the UPTD Puskesmas Nursing Ngletih Kediri City with a value of p = 0.001 (p <0.05; CI = 95% )

The present work was aimed to identify phytochemicals in methanol extract P. brevicaule alba Thom - CC200, obtained from C. cristata , by qualitative and TLC analysis and evaluation of α-amylase inhibitory activity in vitro. It was determined the presence in the extract of glycosides, terpenoids, and saponins. The partitioning of the extract by TLC showed that inhibition of enzyme activity at 50,3% and 37,6% is associated with two compounds of saponin nature.

The aim of the research was to study red blood cells in type II diabetes mellitus (DM),
both an independently occurring disease, and in combination with hypertension, using
innovative research methods (atomic force and scanning electron microscopy with
elemental analysis). In the course of the study, we observed 20 patients aged 40 to 50
years. All of them were divided into groups of 5 people: without somatic and endocrine
pathology and infectious diseases; with moderate type II DM; stage II hypertension;
with a combination of type II DM and hypertension. Each has passed the necessary set
of generally accepted clinical and laboratory examination methods together with related
specialists (therapist, endocrinologist, neurologist, ophthalmologist). Blood was taken
from each patient for subsequent light, atomic force and scanning electron microscopy.
A morphometric analysis of the tissues in the Ntegra-Aura instrument was also
performed. We observed the most pronounced changes in the structure of erythrocytes
in people with a combination of type II DM and hypertension: the number of
degenerative forms increases sharply, and the number of discocytes decreases. In this
regard, such altered red blood cells can’t perform their functions in full. The article
substantiates the possibility and future prospects of using atomic force and scanning
electron microscopy with elemental analysis for independent type II DM, and in
combination with arterial hypertension.

The aim of the study was to develop new approaches to the study of modern aspects of
the clinical and morphological features of uterine blood flow in type I diabetes mellitus
(DM) in the mother. Under our supervision, there were 40 pregnant women with type I
DM. Clinical examination methods generally accepted in obstetric practice were used to
assess the condition of the fetus, placenta, and blood flow in the fetal vessels and uterine
arteries. Light microscopy, atomic force microscopy (AFM), and scanning electron
microscopy (SEM) of 2 uterine fragments obtained during cesarean section were
performed. Samples were examined using a FE1 Quanta 200 3D scanning microscope,
analyzed, and morphometric and imaging were performed. Processing AFM images was
formulated using the NOVA software (NT-MDT, Russian Federation). Results obtained
allow us to judge the adverse effect of diabetes on the mother's body during pregnancy
and childbirth. Among the complications of pregnancy, it should be noted: the state of
preeclampsia (8%), fetoplacental insufficiency (88%), the threat of abortion (52%),
polyhydramnios (25%).Morphologically, we revealed plethora of the endometrium. A
change in the shape of the myometrium with the presence of fragmentary destructive
changes in the myometrium, including focal necrosis and damage to the vascular system
of the pregnant uterus. The paper substantiates the possibility of using scanning electron
and atomic force microscopy as express methods for morphofunctional diagnosis of a
woman's condition in pregnancy pathology

The result of Indonesia Basic Health Research in 2018 showed an increase in the percentage of people with diabetes mellitus. This study aimed to analyze economic losses due to diabetes mellitus in National Health Insurance (NHI) participants with insurance fee waiver (IFW) and non-insurance fee waiver (IFW). This research was a quantitative study with a cross-sectional design. The sample of this study was 17 patients with IFW and 15 patients with non-IFW. The instrument used in this study was a questionnaire consisting of questions about the variable characteristics of the respondents and the direct and indirect costs that should be paid for treatment. Economic losses due to diabetes mellitus were analyzed through direct and indirect total costs.The economic loss for patients with IFW was IDR 5,572,366. Meanwhile, the economic loss for patients with non-IFW was IDR 2,989,984. So, the biggest economic loss due to diabetes mellitus was found in patients with IFW. This was very high when compared to their average income of around IDR 634,375. This can happen because the NHI participants have not taken full advantage of the use of NHI.

This study designed to compare the vital role of the inflammatory immune responses and autoimmunity in development both types of diabetic mellitus by measurement of serum IL-17 , and Anti-Gad levels among patients groups and healthy by using ELISA kits . The study included sixty DM patients were divided into two groups : 30 patients with Type I DM ( 33.7% ) , and 30 patients with Type II DM (33.7%) . In addition to 29 healthy individuals were (32.6 %) . The results indicated an elevated mean serum level of IL-17 and Anti-Gad in both patients groups , as compared with the healthy control with significant difference . Also, the findings recorded a highly significant difference in IL-17 and Anti-Gad sera levels between both types of patient groups at (P< 0. 01) . According to the correlation results between IL-17 and Anti-Gad in patients groups , the data was demonstrated that the expression of IL-17 had a significant positive correlation with expression of Anti-Gad (P< 0.05) among Type I patients . Whereas an inverse very weak correlation was observed between IL-17 and Anti-Gad with no significant (P ˃ 0.05) in Type 2 patients . we concluded the an elevated levels of IL-17A in both types of DM may be as a prognostic factor for development them in Iraqi population. We also conclude that elevated Anti-Gad in Type II DM may be an indication of the rapid development of undiagnosed insulin deficiency in latent autoimmune diabetes in adult patients .

The objective of this article is to provide an overview on the association between Prion proteins and diabetes mellitus which is important so as to understand the aetiology of diabetes mellitus and provide better treatment plans. Prions are misfolded proteins Which have the ability to transmit their misfolded structure to normal variants of the same protein. Prions form abnormal aggregates of protein known as amyloids. Islet amyloid polypeptide, IAPP, is a precursor protein which causes islet amyloid polypeptide amyloidosis, AIAPP, and is said to lead to type two diabetes. Prion aggregates are generally stable and resist proteolysis. Diabetes mellitus is a group of metabolic disorders characterised by high blood sugar level over a long period of time. It is mainly caused by insulin deficiency or resistance. Prion mediated diseases are generally neurodegenerative disorders such as Kuru, Parkinson's disease, Alzheimer's disease etc. There are two isoforms of prions which are PrP and PrPSc. PrPSc is the infective form and is capable of converting PrPC into infective state. In this review, we discuss the association of prion protein with diabetes mellitus, the structure and propagation of Prion proteins and the link between diabetes mellitus and other prion mediated diseases via cross seeding. A review has been done in order to understand and analyse the association between prion protein and diabetes mellitus by retrieving a minimum of 20 articles from various data search engines including pubmed, Google scholar, MESH, core, bioRXiv, Semantic scholar and so on. This review gives a clear understanding of prion proteins, their structure, propagation and disease causing abilities. It is also analyzed that diabetes mellitus could not be just a disease which is caused by insulin deficiency or resistance but could also be the consequence of protein misfolding.

Orofacial infections of odontogenic origin have long plagued mankind. The discovery of the miracle drug
by fleming in the year 1928 and the routine use of penicillin after the landmark discovery of the powder
form of the antibiotic by florey and chain leading to significant change in the management of odontogenic
infection .The spread of infection is governed by factors such as impaired host defence, the virulence of
microorganism, functional abnormalities of the host and a lack of or delayed treatment. the microbiology
of odontogenic infections in diabetic and non-diabetic individuals has been found to be variable. Though
the effects of diabetes can affect infection severity , length of hospital stay, susceptibility to antibiotics
and outcome of treatment is unassured . Differentiation in antibiotics prescribed is also observed.The aim
of the study was to analyse the prevalence of the use of antibiotics among diabetic and non-diabetic
patients in a south indian dental university clinic . The list of all diabetics and non diabetics patients
treated for pain, dental infections , swelling were retrieved by reviewing 86000 patient records who have
visited the hospital during the study periods from june 2019 to march 2020 from the university
database.Data tabulation was carried out in Excel. The data was imported and transcribed in Statistical
Package for Social sciences version 16(SPSS,IBM corporation). Descriptive analysis was carried out.A
total of 9128 patients were included in the study based on treatment done of which 580 patients(6.3%) had
diabetes mellitus. Only 3.5 % of the male population and 2.8% of the female population has
diabetes.Amoxicillin 93.2% was found to be the most frequently prescribed antibiotics among nondiabetic
patients and diabetics patients 1.6% .A combination of metronidazole and amoxicillin was
prescribed to 0.5% of the whole study population .A combination clavulanic acid and
amoxicillin(augmentin )was prescribed to 4 % of the total diabetic study population and 0.4% of the nondiabetic
study population that is about.The relation between the diabetic status of a patient and the
antibiotic prescribed showed a significant statistical relationship in a Pearson's Chi square test with p value
of 0.001(p<0.005).The prescribing practises in dental offices can be improved by increasing awareness
among dental practitioners about the recommended guidelines for prescribing antibiotics . The most
commonly prescribed antibiotics among diabetic patients was Augmentin (4.08%) and for non diabetics it
was amoxicillin (93.25%). .

Background:
       Saudi Arabia is considered to be one of the highest countries in the Middle East for the incidence of diabetes mellitus. Data are lacking regarding knowledge about diabetes mellitus among school students in Saudi Arabia. Diabetes mellitus is a major metabolic disorder currently affecting over 350 million people worldwide. Also, another one billion people in the world are pre-diabetic, who may eventually end up with full- blown diabetes. Type 2 diabetes mellitus is fast becoming a global epidemic and the number of individuals with diabetes in the world is expected to reach 330 million by 2030. The rate of T2DM is rapidly increasing in developing countries, particularly among younger age groups a cross-sectional study indicated that Saudi adolescents exhibited more health-related knowledge than the older population; the majority of the adolescents believed that obesity was dangerous and that regular exercise was beneficial for their health. Saudi adolescents are at a high risk of developing diabetes as many suffer from obesity, a sedentary lifestyle and hereditary diabetes. In 2004, almost a quarter (23.7%) of the Saudi population was diagnosed with T2DM; this was 10 times the number of diabetic individuals in 1980.6 The occurrence of T2DM has been linked to the high rate of overweight adults (35.5%) in the Saudi population and the number of overweight and obese Saudi adolescents is high among both genders.
Aim of the study: The study aimed to assess the knowledge of diabetes mellitus among secondary school students at the Makkah in Saudi Arabia 2019.
Method: cross sectional descriptive study conducted among secondary school students at Makkah, during the April to June, 2019, the Sample size of diabetic secondary school students. Our total participants were (500).
Results:knowledge of the participant toward diabetes mellitus study results show the majority of participant had average information were(61.0%) while weak knowledge were (31.0%) the data ranged from (4-13) by mean ±SD (9.011±2.314).
Conclusion: The level of knowledge and awareness of a considerable number of high school students regarding DM was inadequate, and some of them possessed various misconceptions about this particular chronic disease. Health authorities and school authorities in the region should offer special efforts to improve the level of knowledge and awareness of the students through regular health education campaigns.Diabetes Day should be celebrated in all schools and workshops and lectures given by professionals in collaboration with Ministry of Health on this day are recommended to increase the level of awareness of diabetes